Provider First Line Business Practice Location Address:
818 N CUSHING AVE
Provider Second Line Business Practice Location Address:
STE A
Provider Business Practice Location Address City Name:
KAPLAN
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70548-2615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-643-8881
Provider Business Practice Location Address Fax Number:
337-643-1990
Provider Enumeration Date:
10/13/2008