| NPI | 1952475311 |
|---|---|
| Doing Business As | LAKE INTERNAL MEDICINE AT HENNESSY |
| Entity Type | Organization |
| Authorized Contact | MYRTHA AVANTS Sr Region Operations Manager 225-202-8078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: LA 015394) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-11-21 |