Provider First Line Business Practice Location Address:
1701 OAK PARK BLVD
Provider Second Line Business Practice Location Address:
ER DEPT
Provider Business Practice Location Address City Name:
LAKE CHARLES
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70601-8911
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-494-3036
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/01/2007