MEDICARE: MS. HEATHER ANN ORGERON MT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247200000X	Other Technician	CLP.T00780-TCH	LA

General Provider Information

NPI Number	:	1750408886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HEATHER ANN ORGERON MT

Provider Business Mailing Address
First Line	:	424 ARISTILE RD
Second Line	:
City	:	MORGAN CITY
State	:	LA
Zip	:	70380-7511
Country	:	US
Telephone Number	:	337-217-3571
Fax Number	:

Provider Business Practice Location Address
First Line	:	424 ARISTILE RD
Second Line	:
City	:	MORGAN CITY
State	:	LA
Zip	:	70380-7511
Country	:	US
Telephone Number	:	337-217-3571
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	07/08/2007

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