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Organization
GREEN CLINIC LLC
Active
Organization
GREEN CLINIC LLC
Active
Other names
QUICKCARE OF RUSTON
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER ANDING STEGALL (CFO)
(318) 251-6304
Entity
Organization
Contact information
Practice address
1809 NORTHPOINTE LN STE 102, RUSTON, LA 71270-3852
(318) 255-3762
Mailing address
1200 S FARMERVILLE ST, RUSTON, LA 71270-5941
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
03/04/2019
Last updated
03/04/2019
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