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General NPI Number Information
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NPI Number | 1013344183
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Entity Type | Organization
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Legal Business Name | VENUS/NEUROPATHY TREATMENT CENTERS OF LA,LLC
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Dates
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Enumeration Date | 10/03/2013
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Last Update Date | 10/03/2013
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Provider Practice Location Address
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Address Line | 3233 S SHERWOOD FOREST BLVD SUITE110
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City | BATON ROUGE
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State | LA
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Zip | 70816-2250
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Country | US
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Telephone | 225-636-5184
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Fax | 225-636-5185
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Provider Business Mailing Address
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Address Line | 77191 HWY 25
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City | COVINGTON
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State | LA
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Zip | 70435
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Country | US
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Telephone | 225-636-5184
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Fax | 225-636-5185
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Authorized Official
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Title or Position | MANAGER
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Name | WILLIAM HUVAL
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Credential |
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Telephone | 561-315-2183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 015155
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License Number State | LA
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