| South Louisiana Wellness Services Llc | |
|
4266 W Main St Ste 100 Gray LA 70359-6421 | |
| (985) 856-7893 | |
| (985) 346-6944 |
| Full Name | South Louisiana Wellness Services Llc |
|---|---|
| Speciality | General Practice |
| Location | 4266 W Main St Ste 100, Gray, Louisiana |
| Authorized Official Name and Position | Pamela Dupont (AGENT) |
| Authorized Official Contact | 9858567893 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Louisiana Wellness Services Llc 4266 W Main St Ste 100 Gray LA 70359-6421 Ph: (985) 856-7893 | South Louisiana Wellness Services Llc 4266 W Main St Ste 100 Gray LA 70359-6421 Ph: (985) 856-7893 |
| NPI Number | 1700257615 |
|---|---|
| Provider Enumeration Date | 10/19/2015 |
| Last Update Date | 10/19/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700257615 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |