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General NPI Number Information
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NPI Number | 1245407931
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Entity Type | Organization
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Legal Business Name | DR CONCEPCION & ASSOCIATES THERAPEUTIC CTR
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 03/10/2014
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Provider Practice Location Address
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Address Line | 1131 RUE DU BELIER
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City | LAFAYETTE
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State | LA
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Zip | 70506-6532
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Country | US
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Telephone | 337-981-1400
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Fax | 337-981-6611
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Provider Business Mailing Address
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Address Line | 1131 RUE DU BELIER
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City | LAFAYETTE
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State | LA
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Zip | 70506-6532
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Country | US
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Telephone | 337-981-1400
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Fax | 337-981-6611
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MRS. VIOLETA CONCEPCION
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Credential | CFO
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Telephone | 337-981-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 11294R
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License Number State | LA
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