Organization
MARINGOUIN MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLIE BERTRAND CFNP (OWNER)
(225) 625-2313
Entity
Organization
Contact information
Practice address
77695 WAGLEY RD, MARINGOUIN, LA 70757-0098
(225) 625-2313
(225) 625-2424
Mailing address
PO BOX 98, MARINGOUIN, LA 70757-0098
(225) 625-2313
(225) 625-2424
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/14/2007
Last updated
12/14/2007
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