Provider First Line Business Practice Location Address:
2020 GRAVIER ST
Provider Second Line Business Practice Location Address:
LSU DEPT OF EMERGENCY MEDICINE, 7TH FLOOR, SUITE D
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70112-2272
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-903-3594
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/11/2008