Provider First Line Business Practice Location Address:
2770 3RD AVE
Provider Second Line Business Practice Location Address:
SUITE 350 LAKE CHARLES MEMORIAL HOSPITAL INTERNAL MEDIC
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-494-6800
Provider Business Practice Location Address Fax Number:
337-494-6811
Provider Enumeration Date:
03/26/2007