Provider First Line Business Practice Location Address:
DEPT OF ELCF--LAKEFRONT
Provider Second Line Business Practice Location Address:
UNIVERSITY OF NEW ORLEANS
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70148-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-280-6026
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/02/2006