Jason Fanguy's National Provider Identifier (NPI) Details
Jason Fanguy,
NPI: 1538520796
Enumeration Date: 2016-03-16
Last updated: 2023-10-03
Sole Proprietor: YES
Status: active
Postal Address: 3398 BROOKWOOD DR, HOUMA, LA
Phone: 985-856-2990
Primary Practice Address: 235 CIVIC CENTER BLVD, HOUMA, LA
Practice's phone: 985-333-2020