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9930 Lake Forest Blvd Ste. B New Orleans LA 70127-5483 | |
(504) 512-2206 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 9930 Lake Forest Blvd, New Orleans, Louisiana |
Authorized Official Name and Position | Mark D Callender (OWNER) |
Authorized Official Contact | 5045122206 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3723 Delaware Ave Kenner LA 70065-3025 Ph: () - | 9930 Lake Forest Blvd Ste. B New Orleans LA 70127-5483 Ph: (504) 512-2206 |
NPI Number | 1457648321 |
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Provider Enumeration Date | 06/29/2011 |
Last Update Date | 06/29/2011 |
Identifier | Type | State | Issuer |
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1457648321 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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