Healthcare Provider Details

I. General information

NPI: 1578821948
Provider Name (Legal Business Name): DYSON & DYSON INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2012
Last Update Date: 04/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 MESSINA ST.
ABBEVILLE LA
70510
US

IV. Provider business mailing address

322 MESSINA ST.
ABBEVILLE LA
70510
US

V. Phone/Fax

Practice location:
  • Phone: 337-422-8211
  • Fax:
Mailing address:
  • Phone: 337-422-8211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateLA

VIII. Authorized Official

Name: MRS. TEAQULIA QURENNA PLOWDEN
Title or Position: MANGER
Credential:
Phone: 337-422-8211