Provider First Line Business Practice Location Address:
501 LAPALCO BLVD
Provider Second Line Business Practice Location Address:
JENCARE NEIGHBORHOOD MEDICAL CENTER WB, LLC
Provider Business Practice Location Address City Name:
GRETNA
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70056
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-393-4376
Provider Business Practice Location Address Fax Number:
504-393-4381
Provider Enumeration Date:
03/24/2012