Provider First Line Business Practice Location Address:
1522 HOSPITAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70538-0323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-828-0989
Provider Business Practice Location Address Fax Number:
337-828-3414
Provider Enumeration Date:
08/25/2006