Lakeside Medical Wellness Clinic

NPI 1235315516 - Preferred Provider Organization - 305R00000X

NPI Details
NPI 1235315516
Enumeration Date 01/16/2008
Last Updated 04/20/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name GEORGE E GEORGE
Position OWNER
Phone (337) 527-9529
Fax (337) 527-5049
Practice Location
110 E DARBONNE ST STE B
SULPHUR LA, 70663-4958, US
Phone (337) 527-9529
Fax (337) 527-5049
Business Location
110 E DARBONNE ST STE B
SULPHUR LA, 70663-4958, US
Phone (337) 527-9529
Fax (337) 527-5049
Toxanomy
Taxonomy Code 305R00000X
License State Louisiana
License Number =========
Remove 1235315516 NPI Number
 

According to our database, Lakeside Medical Wellness Clinic NPI is 1235315516, taxonomy code is 305R00000X and license number is =========, license state is located at Louisiana. Lakeside Medical Wellness Clinic physically located at 110 E Darbonne St Ste B, Sulphur LA, 70663-4958. NPI Number 1033115704 has the healthcare provider type.

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1235315516 NPI number is provided on an as is basis without warranty of any kind. 1235315516 is maintained by the National Plan & Provider Enumeration System. The contents of Lakeside Medical Wellness Clinic are for informational purposes only.