L GLEN MIRE MD INC
Osteopathic Medicine at Dulles Dr, Lafayette, LA

License number
Louisiana 012202
Category
Osteopathic Medicine
Type
Geriatric Medicine
Owner
Name: DR. LOUIS GLEN MIRE MD
Title: OWNER
Phone: (337) 981-0305
Address
Address
324 Dulles Dr, Lafayette, LA 70506
National Provider ID: 1134328966
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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L. GLEN MIRE, M.D., INC. (A PROFESSIONAL MEDICAL CORPORATION)

Lafayette, LA

Industry:
Medical Doctor's Office
Registration:
May 14, 2001
Addresses:
207 Travailleur Rd, Lafayette, LA 70506 (Physical)
207 Travailler Rd, Lafayette, LA 70506
State ID:
35088308D
Business type:
Business Corporation
Principals:
L. Glen Mire, M.d (Director, President, Secretary/Treasurer), 207 Travailleur Rd, Lafayette, LA 70506 (Physical),L. G. Mire Principal, inactive

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