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General NPI Number Information
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NPI Number | 1255010617
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Entity Type | Organization
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Legal Business Name | TORS MEDICAL CLINIC, LLC
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Dates
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Enumeration Date | 07/13/2023
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | 3920 MAPLEWOOD DRIVE
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City | SULPHUR
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State | LA
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Zip | 70663-6209
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Country | US
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Telephone | 337-476-5071
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Fax | 337-476-5061
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Provider Business Mailing Address
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Address Line | PO BOX 3311
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City | SULPHUR
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State | LA
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Zip | 70664-3311
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Country | US
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Telephone | 337-476-5071
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Fax | 337-476-5061
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Authorized Official
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Title or Position | OWNER
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Name | JAMIE AVERETT KLUMPP
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Credential | APRN
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Telephone | 337-476-5071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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