Most Relevant Information
Provider Data
| NPI Number: | 1003465998 |
| Provider Name: | JERRICA M KING |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/04/2019 |
| Last Updated: | 09/04/2019 |
Provider Practice Location
1333 COMMON ST
LAKE CHARLES
LA
706015255
Practice Location Phone/Fax
| Phone: | 3374374014 |
| Fax: |
Provider Mailing Location
1333 COMMON ST
LAKE CHARLES
LA
706015255
Provider Mailing Phone/Fax
| Phone: | 3374374014 |
| Fax: |