Organization
GRACE GYNECOLOGY & WELLNESS CORP APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MIKA MARLAINE KING M.D. (PHYSICIAN/PRESIDENT OF CORP)
(337) 654-4729
Entity
Organization
Contact information
Practice address
200 BEAULLIEU DR STE 3B, LAFAYETTE, LA 70508-7230
(337) 522-7282
(337) 393-7057
Mailing address
200 BEAULLIEU DR STE 3B, LAFAYETTE, LA 70508-7230
(337) 522-7282
(337) 393-7057
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
10/06/2021
Last updated
01/12/2022
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