Provider First Line Business Practice Location Address:
721 ST. PHILIP STREET
Provider Second Line Business Practice Location Address:
KIPP MCDONOGH 15 PRIMARY
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-335-1935
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/05/2011