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1205454774
JACKSON STREET PEDIATRICS, LLC
ALEXANDRIA, LA
NPI
1205454774
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Entity Type
Organization
Authorized Contact
KAI A WICKER-BROWN
Owner
313-300-3637
Organization Subpart ?
No
Primary Taxonomy
208000000X Pediatrics
Enumeration Date
2020-07-10
Last Update Date
2020-07-10
Business Address
JACKSON STREET PEDIATRICS, LLC
5716 JACKSON ST
ALEXANDRIA, LA 71303-2042
Phone number: 318-767-6503
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Mailing Address
JACKSON STREET PEDIATRICS, LLC
6326 WINDY OAKS
ALEXANDRIA, LA 71301-2966
Phone number: 313-300-3637
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