Individual
JENNIFER LYNNE STANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
10401 WARE ST, RIVER RIDGE, LA 70123
(225) 400-2578
Mailing address
10401 WARE ST, RIVER RIDGE, LA 70123
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
04635
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04635
LASBPTE
LA
Enumeration date
06/01/2021
Last updated
06/01/2021
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