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Organization

DRY PRONG FAMILY CLINIC, LLC

Active
Other names
Dry Prong Family Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
BENJAMIN COLVIN FNP (OWNER)
(318) 568-8298
Entity
Organization

Contact information

Practice address
800 GROVE STREET, DRY PRONG, LA 71423
(318) 568-8298
(318) 568-8297
Mailing address
PO BOX 37, MONTGOMERY, LA 71454-0037

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
261QR1300X
Rural Health Clinic/Center
Primary

Other

Enumeration date
07/13/2018
Last updated
06/02/2020
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