Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist |
NPI | 1083176085 |
---|---|
Provider Name | Mrs. Brandy Larie Mcneal |
First Address | Harvey, LA 70058-2311 |
Second Address | Harvey, LA 70058-2311 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2019 |
Last Update Date | 01/04/2019 |