PRESTIGE PRIMARY CARE PLLC

LAFAYETTE, LA
NPI1982087987
Entity TypeOrganization
Authorized ContactLISA KATHERINE TABOR
Owner
337-804-2049
Organization Subpart ?No
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: LA  AP04615)
Enumeration Date2015-07-08
Last Update Date2015-07-08
Business Address
PRESTIGE PRIMARY CARE PLLC
2851 JOHNSTON ST
LAFAYETTE, LA 70503-3243
Phone number: 337-281-6102
Mailing Address
PRESTIGE PRIMARY CARE PLLC
2851 JOHNSTON ST
LAFAYETTE, LA 70503-3243
Phone number: 337-281-6102
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