Organization
MAIN STREET CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURA G CUMMINGS FNP (OWNER, PROVIDER)
(318) 649-3668
Entity
Organization
Contact information
Practice address
115 MAIN ST, COLUMBIA, LA 71418
(318) 649-3668
Mailing address
PO BOX 1615, COLUMBIA, LA 71418-1615
(318) 649-3668
(318) 649-0086
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/09/2011
Last updated
11/23/2011
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