| West State Mht Llc | |
|
379 Peavy Rd Leesville LA 71446-9514 | |
| (855) 860-2109 | |
| Not Available |
| Full Name | West State Mht Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 379 Peavy Rd, Leesville, Louisiana |
| Authorized Official Name and Position | Steven Smith (MANAGER OF REGULATORY COMPLIANCE) |
| Authorized Official Contact | 8558602109 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West State Mht Llc 1515 Heritage Dr Suite 110 Mckinney TX 75069-3379 Ph: (855) 860-2109 | West State Mht Llc 379 Peavy Rd Leesville LA 71446-9514 Ph: (855) 860-2109 |
| NPI Number | 1417379447 |
|---|---|
| Provider Enumeration Date | 01/10/2014 |
| Last Update Date | 01/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417379447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 11865R (Louisiana) | Primary |
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