Organization
THE FOOT CLINIC OF WEST LOUISIANA
Active
Organization
THE FOOT CLINIC OF WEST LOUISIANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE HARVEY (MANAGER)
(337) 239-1061
Entity
Organization
Contact information
Practice address
901 SHIRLEY STREET, DERIDDER, LA 70634
(337) 239-1061
(337) 239-1062
Mailing address
901 SHIRLEY STREET, DERIDDER, LA 70634
(800) 686-7758
(337) 239-1062
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1442348
—
LA
Enumeration date
03/08/2007
Last updated
08/09/2011
Update your record
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