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General NPI Number Information
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NPI Number | 1912124991
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Entity Type | Organization
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Legal Business Name | ADVANCED LASER EQUIPMENT, LLC
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 1001 W PINHOOK RD SUITE 307
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City | LAFAYETTE
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State | LA
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Zip | 70503-2448
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Country | US
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Telephone | 337-234-5679
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 W. PINHOOK RD SUITE 307
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City | LAFAYETTE
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State | LA
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Zip | 70503
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Country | US
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Telephone | 337-234-5679
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AARON BODIN
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Credential |
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Telephone | 337-234-5679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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