Organization · NPI-2

Lice Away LLC

Technician, Other · Lafayette, LA

NPI number1174028344
StatusActive
Last updated in NPPESMar 28, 2018

Details

NPI
1174028344
Entity type
Organization (NPI-2)
Legal business name
Lice Away LLC
Organization subpart
No
Enumeration date
Mar 28, 2018
Last updated
Mar 28, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
247200000X Technician, Other–LAYes

Practice location

100 Beauvais Ave
Lafayette, LA 70507-2468

Phone 337-466-8998

Mailing address

164 Savoie Dr
Eunice, LA 70535-6705

Authorized official

Shanna Montgomery
Owner
3375804027

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