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General NPI Number Information
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NPI Number | 1598950230
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Entity Type | Organization
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Legal Business Name | LEESVILLE SURGERY CENTER LLC
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 1103 PORT ARTHUR TERRACE
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City | LEESVILLE
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State | LA
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Zip | 71446
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Country | US
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Telephone | 225-687-9222
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Fax |
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Provider Business Mailing Address
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Address Line | 1103 PORT ARTHUR TERRACE
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City | LEESVILLE
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State | LA
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Zip | 71446
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, BUSINESS OFFICE SUPPORT
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Name | LAURIE HOLTSFORD
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Credential |
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Telephone | 615-465-7488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | PENDING
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License Number State | LA
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