# AFFINITY HEALTH GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Affinity Family Practice & Wound Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669767638
- **Authorized official:** MR. MIKE BREARD (VICE PRESIDENT)
- **Authorized official phone:** (318) 361-0900

## Contact information

- **Practice address:** 920 OLIVER RD \# J, MONROE, LA 71201-5702
- **Practice address phone:** (318) 807-3700
- **Practice address fax:** (318) 807-0014
- **Mailing address:** 130 DESIARD ST, STE 355, MONROE, LA 71201-7319
- **Mailing address phone:** (318) 807-7875
- **Mailing address fax:** (318) 812-6603

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 06/17/2011
- **Last updated:** 05/28/2020