STATE OF LOUISIANA
Organization (NPI-2)
Active
Family Medicine, Sports Medicine
Provider Information
- NPI Number
1578950028- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 548 WESTERN AVE, HAMMOND, LA, 704020001
- Phone
- (972) 367-4845
- Fax
- (972) 367-3451
Specialties & Taxonomies
Orthopaedic Surgery
Family Medicine, Sports Medicine
Primary