Organization
M V JOHN M D LLC
Active
Other names
Interventional Spine and Rehabilitation of Louisiana
Organization subpart
No
Provider details
NPI number
Authorized official
MACKENZIE HAHN (NCPDP COORDINATOR)
(479) 636-9702
Entity
Organization
Contact information
Practice address
4021 W E HECK CT., BUILDING M-1, BATON ROUGE, LA 70816
(479) 636-9702
(877) 427-2307
Mailing address
PO BOX 3328, BENTONVILLE, AR 72712
(479) 636-9702
(877) 427-2307
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
MD202152
LA
Other
Enumeration date
10/12/2017
Last updated
11/15/2017
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