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1700092442
PROVIDENCE MEDICAL CLINIC
BATON ROUGE, LA
NPI
1700092442
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Entity Type
Organization
Authorized Contact
CUONG MINH PHO
Office Manager
225-766-8152
Organization Subpart ?
No
Primary Taxonomy
261QP2300X Clinic/Center, Primary Care
Enumeration Date
2007-05-16
Last Update Date
2020-08-22
Business Address
PROVIDENCE MEDICAL CLINIC
9270 SIEGEN LN SUITE 202
BATON ROUGE, LA 70810-1998
Phone number: 225-766-8152
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Mailing Address
PROVIDENCE MEDICAL CLINIC
1229 TANGLEBRIAR DR
BATON ROUGE, LA 70810-5195
Phone number: 225-766-4213
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