Provider First Line Business Practice Location Address:
1070 JONESBORO ROAD
Provider Second Line Business Practice Location Address:
GPI - PLANT 70 MEDICAL CENTER
Provider Business Practice Location Address City Name:
WEST MONROE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71292
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-362-2099
Provider Business Practice Location Address Fax Number:
318-362-2775
Provider Enumeration Date:
12/22/2008