Provider First Line Business Practice Location Address:
1009 HIGHWAY 80 EAST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CALHOUN
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71225
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-644-3911
Provider Business Practice Location Address Fax Number:
318-644-3933
Provider Enumeration Date:
01/26/2007