Organization
THE WILL OF GOD MINISTRIES OUTREACH PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHNNY COX (EXECUTIVE DIRECTOR)
(318) 932-3177
Entity
Organization
Contact information
Practice address
1113 CALIOPE STREET, COUSHATTA, LA 71019
(318) 932-3177
Mailing address
1113 CALIOPE STREET, COUSHATTA, LA 71019
(318) 932-3177
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
10775
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454371
—
LA
Enumeration date
02/26/2007
Last updated
09/11/2007
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