Provider First Line Business Practice Location Address:
35701 LA HIGHWAY 16
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENHAM SPRINGS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70706-0548
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-791-2400
Provider Business Practice Location Address Fax Number:
225-791-4400
Provider Enumeration Date:
06/04/2006