Provider First Line Business Practice Location Address:
3194 HWY 71
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMPTI
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-214-4200
Provider Business Practice Location Address Fax Number:
318-214-4493
Provider Enumeration Date:
04/24/2007