Provider First Line Business Practice Location Address:
601EAST MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VILLE PLATTE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70586
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-363-7766
Provider Business Practice Location Address Fax Number:
337-363-1092
Provider Enumeration Date:
01/22/2007