Provider First Line Business Practice Location Address:
2D MEDICAL GROUP, BLDG 4548
Provider Second Line Business Practice Location Address:
243 CURTISS RD
Provider Business Practice Location Address City Name:
BARKSDALE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-514-5811
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/04/2011