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Organization

METAIRIE TOTAL WELLNESS CLINIC, LLC

Active
Parent organization
MODERN MALE T-CLINIC, P.A.
Organization subpart
Yes

Provider details

NPI number
Legal business name
MODERN MALE T-CLINIC, P.A.
Authorized official
SALVATORE CAMPO DO (DO / PHYSICIAN)
(214) 714-5343
Entity
Organization

Contact information

Practice address
1813 VETERANS MEMORIAL BLVD STE B, METAIRIE, LA 70005-2637
(800) 246-5698
Mailing address
5000 ELDORADO PKWY STE 150-153, FRISCO, TX 75033-8695

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207QA0505X
Adult Medicine Physician
Primary

Other

Enumeration date
05/07/2018
Last updated
05/07/2018
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