| 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 |