Provider First Line Business Practice Location Address:
730 CELEBRITY DRIVE
Provider Second Line Business Practice Location Address:
AMERICAN STAT CARE CENTER
Provider Business Practice Location Address City Name:
RUSTON
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71270
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-255-2100
Provider Business Practice Location Address Fax Number:
318-255-2040
Provider Enumeration Date:
08/31/2006