Organization
MOBILE X-RAY OF LOUISIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMY A. HEBERT (OWNER)
(337) 412-6702
Entity
Organization
Contact information
Practice address
1021 COOLIDGE BLVD, LAFAYETTE, LA 70503-2435
(337) 412-6702
Mailing address
910 HARDING ST, LAFAYETTE, LA 70503-2450
(337) 412-6702
Taxonomy
Speciality
Code
Description
License number
State
261QR0207X
Mobile Mammography Clinic/Center
Primary
—
LA
Other
Enumeration date
12/30/2009
Last updated
12/30/2009
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