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Organization
WEST STATE ORTHOPEDICS AND SPORTS MEDICINE CLINIC
Active
Organization
WEST STATE ORTHOPEDICS AND SPORTS MEDICINE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN PATRICK GRANGER M.D. (PHYSICIAN / OWNER)
(337) 392-2330
Entity
Organization
Contact information
Practice address
506 S 6TH ST, SUITE B, LEESVILLE, LA 71446-4442
(337) 392-2330
(337) 392-2580
Mailing address
506 S 6TH ST, SUITE B, LEESVILLE, LA 71446-4442
(337) 392-2330
(337) 392-2580
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
11865R
LA
Other
Enumeration date
05/08/2006
Last updated
08/22/2020
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