NPI 1699599035

Clyde D Portis

Practitioner Lodging Provider Hornbeck, LA

Practice location

Address: 377 Charles Miller Rd, Hornbeck, LA 71439-1610
Phone: (346) 435-4892

Registered specialties

Lodging Provider Primary

Other Service Providers Taxonomy 177F00000X

Other Lodging providers in Louisiana →

Registry record

NPI: 1699599035
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Nov 2024
Record last updated: 12 Nov 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.