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General NPI Number Information
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NPI Number | 1376942870
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Entity Type | Organization
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Legal Business Name | TRICIA H LEGE OD LLC
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Dates
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Enumeration Date | 08/20/2014
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Last Update Date | 08/20/2014
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Provider Practice Location Address
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Address Line | 204 N SAINT CHARLES ST
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City | ABBEVILLE
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State | LA
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Zip | 70510-5106
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Country | US
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Telephone | 337-740-2020
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Fax | 337-740-2022
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Provider Business Mailing Address
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Address Line | 204 N SAINT CHARLES ST
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City | ABBEVILLE
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State | LA
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Zip | 70510-5106
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Country | US
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Telephone | 337-740-2020
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Fax | 337-740-2022
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. TRICIA H LEGE
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Credential | O.D.
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Telephone | 337-740-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1261-415T
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License Number State | LA
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