Mary Necoloa Fontenot
Contractor, Vehicle Modifications in Lake Charles, LA. Individual provider (NPI-1).
NPI number1346744042
StatusActive
Last updated in NPPESMar 19, 2018
Details
- NPI
- 1346744042
- Entity type
- Individual (NPI-1)
- Name
- Mary Necoloa Fontenot
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 19, 2018
- Last updated
- Mar 19, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171WV0202X | Contractor, Vehicle Modifications | 008907424 | LA | Yes |
Practice location
1324 Rosetta StLake Charles, LA 70607-1932
Phone 337-912-8617
Mailing address
1324 Rosetta StLake Charles, LA 70607-1932
Phone 337-912-8617
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