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Organization
ALL AGE MEDICAL P.C., INC.
Active
Organization
ALL AGE MEDICAL P.C., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREA NATALIE BLAKE-MCMAHON M.D. (CEO)
(318) 741-8100
Entity
Organization
Contact information
Practice address
2910 SHED RD, SUITE B, BOSSIER CITY, LA 71111-3154
(318) 741-8100
(318) 741-5700
Mailing address
2910 SHED RD, SUITE B, BOSSIER CITY, LA 71111-3154
(318) 741-8100
(318) 741-5700
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
14851R
LA
Other
Enumeration date
11/05/2007
Last updated
01/20/2012
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