| Organization Name: | NATCHITOCHES URGENT CARE CLINIC |
| NPI Number: | 1053635987 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LAVORA WILSON (OWNER/FNP) |
| Mailing Address: | 615 Bienville St Natchitoches |
| State: | LA US |
| Postal Code: | 714575730 |
| Phone Number: | 3183565566 |
| Fax Number: | 3189329906 |
| NPI Enumeration Date: | 03/22/2010 |
| NPI Last Update Date: | 03/22/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |