# CHAIR MRI OF LOUISIANA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891124889
- **Authorized official:** CHRISTOPHER BRUCE GERVAIS (OWNER/MANAGER)
- **Authorized official phone:** (985) 893-4222

## Contact information

- **Practice address:** 2639 N CAUSEWAY BLVD, MANDEVILLE, LA 70471-6435
- **Practice address phone:** (985) 893-4222
- **Practice address fax:** (985) 893-4026
- **Mailing address:** 2639 N CAUSEWAY BLVD, MANDEVILLE, LA 70471-6435
- **Mailing address phone:** (985) 893-4222
- **Mailing address fax:** (985) 893-4026

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | 40873367K | LA | Yes |

## Other

- **Enumeration date:** 11/11/2013
- **Last updated:** 04/23/2014