Organization Name: | FAMILY HEALTHCARE CLINIC, APMC |
NPI Number: | 1437341278 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DANIEL WILTZ (PRESIDENT) |
Mailing Address: | 1117 N Main St Ste B Saint Martinville |
State: | LA US |
Postal Code: | 705823513 |
Phone Number: | 3373947111 |
Fax Number: | 3373948105 |
NPI Enumeration Date: | 08/15/2007 |
NPI Last Update Date: | 08/15/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 023274 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |