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Organization
DRY PRONG FAMILY CLINIC, LLC
Active
Organization
DRY PRONG FAMILY CLINIC, LLC
Active
Other names
Dry Prong Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN COLVIN FNP (OWNER)
(318) 568-8298
Entity
Organization
Contact information
Practice address
800 GROVE STREET, DRY PRONG, LA 71423
(318) 568-8298
(318) 568-8297
Mailing address
PO BOX 37, MONTGOMERY, LA 71454-0037
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
NULL
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
07/13/2018
Last updated
06/02/2020
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