MOSS STREET KID MED LLC

LAFAYETTE, LA
NPI1336268184
Entity TypeOrganization
Authorized ContactDESIREE P RICHARD
Onwer
337-291-2411
Organization Subpart ?No
Primary Taxonomy261Q00000X Clinic/Center
Enumeration Date2007-03-29
Last Update Date2009-03-25
Business Address
MOSS STREET KID MED LLC
1417A MOSS STREET
LAFAYETTE, LA 70501
Phone number: 337-291-2411
Mailing Address
MOSS STREET KID MED LLC
1417A MOSS ST
LAFAYETTE, LA 70501-3654
Phone number: 337-291-2411
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