| |
1528 E. Prien Lake Rd.,, Ste. B, Lake Charles, LA 70601 | |
(337) 479-2057 | |
(337) 479-2099 |
Full Name | |
---|---|
Type | Facility |
Speciality | Family Medicine |
Location | 1528 E. Prien Lake Rd.,, Lake Charles, Louisiana |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770532749 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Primary |
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
1528 E. Prien Lake Rd.,, Ste. B, Lake Charles, LA 70601 Ph: (337) 479-2057 | 1528 E. Prien Lake Rd.,, Ste. B, Lake Charles, LA 70601 Ph: (337) 479-2057 |