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General NPI Number Information
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NPI Number | 1649921065
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Entity Type | Organization
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Legal Business Name | JOINT REPLACEMENT CENTER OF LOUISIANA
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 5150 ROBOTICS LANE
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City | LAKE CHARLES
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State | LA
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Zip | 70605
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Country | US
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Telephone | 337-214-2900
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Fax | 337-214-2966
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Provider Business Mailing Address
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Address Line | 9131 ANSON WAY STE 304
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City | RALEIGH
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State | NC
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Zip | 27615-3267
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Country | US
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Telephone | 727-235-1481
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Fax |
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | STACY DANAHY
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Credential |
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Telephone | 727-235-1481
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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 |
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License Number State |
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