Organization Name: | ADVANTAGE WEIGHT LOSS CLINIC |
NPI Number: | 1275720732 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LEIA A. FRICKEY (PRESIDENT/OWNER) |
Mailing Address: | 3939 Veterans Blvd. Suite 275 Metairie |
State: | LA US |
Postal Code: | 70002 |
Phone Number: | 5044557255 |
Fax Number: | 5044557299 |
NPI Enumeration Date: | 09/28/2007 |
NPI Last Update Date: | 09/28/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 020845 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |