Organization
CENTER FOR NEUROSURGICAL AND SPINE DISORDERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEE F HARLESS (PRACTICE MANAGER)
(337) 478-9653
Entity
Organization
Contact information
Practice address
1614 WOLF CIR, LAKE CHARLES, LA 70605-2348
(337) 478-9653
(337) 474-0988
Mailing address
PO BOX 1786, LAKE CHARLES, LA 70602-1786
(337) 478-9653
(337) 474-0988
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
021935
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1436461
—
LA
05
—
1567949
—
LA
Enumeration date
08/02/2006
Last updated
07/27/2010
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