Provider Demographics
NPI:1316196926
Name:LEMOINE, TRICIA ANN (LMT)
Entity Type:Individual
Prefix:MISS
First Name:TRICIA
Middle Name:ANN
Last Name:LEMOINE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4508 COLISEUM BLVD STE N
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3564
Mailing Address - Country:US
Mailing Address - Phone:318-767-3661
Mailing Address - Fax:318-767-3662
Practice Address - Street 1:4508 COLISEUM BLVD STE N
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3564
Practice Address - Country:US
Practice Address - Phone:318-767-3661
Practice Address - Fax:318-767-3662
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA-252701172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist