| Gruner Clinic, LLC | |
|
6180 Main St Suite B Zachary LA 70791-4069 | |
| (225) 658-5959 | |
| (225) 658-9998 |
| Full Name | Gruner Clinic, LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 6180 Main St, Zachary, Louisiana |
| Authorized Official Name and Position | Rachel Mier Gruner (OWNER) |
| Authorized Official Contact | 2256585959 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gruner Clinic, LLC 6180 Main St Suite B Zachary LA 70791-4069 Ph: (225) 658-5959 | Gruner Clinic, LLC 6180 Main St Suite B Zachary LA 70791-4069 Ph: (225) 658-5959 |
| NPI Number | 1043403918 |
|---|---|
| Provider Enumeration Date | 08/23/2007 |
| Last Update Date | 08/23/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043403918 | NPI | - | NPPES |
| 1444821 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 024988 (Louisiana) | Primary |
| 208600000X | Surgery | 023672 (Louisiana) | Secondary |
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