Healthcare Provider Details

I. General information

NPI: 1285430843
Provider Name (Legal Business Name): CHRISTOPHER SCOTT VIGE B.S, CIT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/24/2025
Certification Date: 02/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 WALL ST STE B
LAFAYETTE LA
70506-3029
US

IV. Provider business mailing address

1000 MARY ANN ST
OPELOUSAS LA
70570-5862
US

V. Phone/Fax

Practice location:
  • Phone: 337-504-5529
  • Fax: 337-332-6758
Mailing address:
  • Phone: 337-693-2447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: