Provider First Line Business Practice Location Address:
500 PATTERSON STREET
Provider Second Line Business Practice Location Address:
SWLA CENTER FOR HEALTH SERVICES
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-769-6537
Provider Business Practice Location Address Fax Number:
337-769-9467
Provider Enumeration Date:
07/24/2006