Organization
RIVERPARK PRIMARY HEALTH CLINIC, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANA MABRY CFNP (ADMINISTRATOR)
(318) 336-2218
Entity
Organization
Contact information
Practice address
107 FRONT STREET, VIDALIA, LA 71373
(318) 336-2218
(318) 336-6066
Mailing address
107 FRONT STREET, VIDALIA, LA 71373
(318) 336-2218
(318) 336-6066
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/05/2010
Last updated
08/05/2010
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