| NPI Details | |
|---|---|
| NPI | 1104244078 |
| Enumeration Date | 03/28/2014 |
| Last Updated | 03/28/2014 |
| Entity Type | Healthcare Provider |
| Active | Over 4 years ago |
| Authorized Information | |
|---|---|
| Name | SHANTELLE SHANTELLE |
| Position | DIRECTOR OF CLINICAL EDUCATION |
| Phone | (504) 621-5247 |
| Fax | |
| Practice Location | |
|---|---|
| 1145 BEECHWOOD DR HARVEY LA, 70058-4332, US |
|
| Phone | (504) 621-5247 |
| Fax | |
| Business Location | |
|---|---|
| 1145 BEECHWOOD DR HARVEY LA, 70058-4332, US |
|
| Phone | (504) 621-5247 |
| Fax | |
| Toxanomy | |
|---|---|
| Taxonomy Code | 282N00000X |
| License State | Louisiana |
| License Number | LRT.000756 |
| Remove 1104244078 NPI Number | |
According to our database, Our Lady Of The Lake Rmc NPI is 1104244078, taxonomy code is 282N00000X and license number is LRT.000756, license state is located at Louisiana. Our Lady Of The Lake Rmc physically located at 1145 Beechwood Dr, Harvey LA, 70058-4332. NPI Number 1033115704 has the healthcare provider type.
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1104244078 NPI number is provided on an as is basis without warranty of any kind. 1104244078 is maintained by the National Plan & Provider Enumeration System. The contents of Our Lady Of The Lake Rmc are for informational purposes only.
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