Provider First Line Business Practice Location Address:
1125 N. TONTI ST.
Provider Second Line Business Practice Location Address:
C/O COMMUNITY MEDICAL CLINIC
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-383-8559
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/15/2015