Organization
COASTAL FOOT CLINIC, A P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD G PALECKI D.P.M. (PRESIDENT)
(225) 718-5314
Entity
Organization
Contact information
Practice address
230 ROBERTS DR, SUITE G, NEW ROADS, LA 70760-2661
(225) 638-6640
(225) 618-0863
Mailing address
PO BOX 575, LIVONIA, LA 70755-0575
(225) 234-0048
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PD165R
LA
Other
Enumeration date
07/21/2011
Last updated
07/21/2011
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