Organization
PRAISE PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONETTE PIERRE-LOUIS M.D. (OWNER)
(928) 855-0520
Entity
Organization
Contact information
Practice address
84 ACOMA BLVD N, SUITE 104, LAKE HAVASU CITY, AZ 86403-6096
(928) 855-0520
(928) 855-0537
Mailing address
PO BOX 3502, LAKE HAVASU CITY, AZ 86405-3502
(928) 855-0520
(928) 855-0537
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
37592
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L13964732
LLC REGISTRATION #
AZ
Enumeration date
10/17/2007
Last updated
10/17/2007
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