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1407147234
LAKESIDE MEDICAL WELLNESS CLINIC
SULPHUR, LA
NPI
1407147234
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Entity Type
Organization
Authorized Contact
STACY W KIRKUM
Administrator
337-625-5050
Organization Subpart ?
No
Primary Taxonomy
261Q00000X Clinic/Center
(Licence: LA MD14484R)
Enumeration Date
2011-04-27
Last Update Date
2011-04-27
Business Address
LAKESIDE MEDICAL WELLNESS CLINIC
1908 MAPLEWOOD DR SUITE B
SULPHUR, LA 70663-6000
Phone number: 337-625-5050
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Mailing Address
LAKESIDE MEDICAL WELLNESS CLINIC
1908 MAPLEWOOD DR SUITE B
SULPHUR, LA 70663-6000
Phone number: 337-625-5050
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