Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 08543 | LA |
NPI | 1003253527 |
---|---|
Provider Name | Renee Oubre Renard |
First Address | Lafayette, LA 70505-1783 |
Second Address | Delcambre, LA 70528-2308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2013 |
Last Update Date | 05/10/2017 |