Organization Name: | T & T KLICK, LLC |
NPI Number: | 1023399888 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TERRI LYNN KLICK (OWNER) |
Mailing Address: | 107 Lela St Mangham |
State: | LA US |
Postal Code: | 712595063 |
Phone Number: | 3182484100 |
Fax Number: | 3182484103 |
NPI Enumeration Date: | 09/06/2011 |
NPI Last Update Date: | 10/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | APO6543 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |