Organization
SRC INTERNATIONAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RACHEL COOPER (MEMBER)
(337) 504-3596
Entity
Organization
Contact information
Practice address
144 BANKS AVE, LAFAYETTE, LA 70506-1988
(337) 504-3596
Mailing address
509 CAMELLIA DR, LAFAYETTE, LA 70503-4701
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
06/19/2010
Last updated
06/19/2010
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