Revision Ink LLC
NPI #1477134203 in Broussard, Louisiana
Provider Information
- NPI Number
- 1477134203
- Entity Type
- Organization
- Organization Name
- Revision Ink LLC
- Primary Specialty
- Specialist/Technologist, Other - Art, Medical
- Enumeration Date
- Apr 14, 2021
- Last Updated
- Apr 14, 2021
Practice Location
Authorized Official
- Name
- AMAINTE B GODEAUX
- Title
- OWNER/OPERATOR
- Phone
- (337) 945-0631
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist, Other - Art, Medical — Art, Medical |
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