Organization
AMAZING CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WANDA J OVITT FNP-C (PRESIDENT)
(318) 202-5935
Entity
Organization
Contact information
Practice address
765 S BONNER ST, RUSTON, LA 71270-5801
(318) 202-5935
(318) 202-5933
Mailing address
PO BOX 1839, RUSTON, LA 71273-1839
(318) 202-5935
(318) 202-5933
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2131320
—
LA
Enumeration date
10/04/2010
Last updated
12/21/2010
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