| Self-ish, Llc | |
|
4310 Ryan St Ste 134 Lake Charles LA 70605-4514 | |
| (337) 873-1203 | |
| Not Available |
| Full Name | Self-ish, Llc |
|---|---|
| Speciality | Counselor |
| Location | 4310 Ryan St Ste 134, Lake Charles, Louisiana |
| Authorized Official Name and Position | Royce Charles (OWNER) |
| Authorized Official Contact | 3378731203 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Self-ish, Llc 4310 Ryan St Ste 134 Lake Charles LA 70605-4514 Ph: (337) 873-1203 | Self-ish, Llc 4310 Ryan St Ste 134 Lake Charles LA 70605-4514 Ph: (337) 873-1203 |
| NPI Number | 1730843012 |
|---|---|
| Provider Enumeration Date | 10/24/2021 |
| Last Update Date | 10/28/2021 |
| Certification Date | 10/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730843012 | NPI | - | NPPES |
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