Organization
M M GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AVIS ROWAN (OWNER/ADMINISTRATOR)
(225) 337-5906
Entity
Organization
Contact information
Practice address
15360 RYAN AVE, PRAIRIEVILLE, LA 70769-4385
(225) 337-5906
(225) 744-3030
Mailing address
15360 RYAN AVE, PRAIRIEVILLE, LA 70769-4385
(225) 337-5906
(225) 744-3030
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
LA
Other
Enumeration date
04/06/2009
Last updated
07/21/2022
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