PEDIATRIC PROVIDERS OF LOUISIANA

SHREVEPORT, LA
NPI1548494578
Doing Business AsMOORETOWN FAMILY CLINIC
Entity TypeOrganization
Authorized ContactJEAN ROUSSEAU
President
318-621-9600
Organization Subpart ?No
Primary Taxonomy261QH0100X Clinic/Center, Health Services
(Licence: LA  06203R)
Enumeration Date2009-05-05
Last Update Date2009-08-21
Business Address
PEDIATRIC PROVIDERS OF LOUISIANA
4140 HOLLYWOOD AVE
SHREVEPORT, LA 71109-7818
Phone number: 318-621-9600
Mailing Address
PEDIATRIC PROVIDERS OF LOUISIANA
4140 HOLLYWOOD AVE
SHREVEPORT, LA 71109-7818
Phone number: 318-621-9600