Healthcare Provider Details
I. General information
NPI: 1215501283
Provider Name (Legal Business Name): TOETAL CARE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/14/2021
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
161 CHRISTIAN DR
RAYVILLE LA
71269-3658
US
IV. Provider business mailing address
161 CHRISTIAN DR
RAYVILLE LA
71269-3658
US
V. Phone/Fax
- Phone: 318-237-6885
- Fax:
- Phone: 318-661-3030
- Fax: 318-661-3032
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213EP1101X |
| Taxonomy | Primary Podiatric Medicine Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANGELA
CLARK
GILL
Title or Position: FAMILY NURSE PRACTITIONER/OWNER
Credential: FNP-C
Phone: 318-661-3030