Organization
CLINICAL CONSULTANTS OF LOUISIANA LLC
Active
Other names
Dimitri Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
MARK D CALLENDER PA-C (OWNER)
(504) 512-2206
Entity
Organization
Contact information
Practice address
9930 LAKE FOREST BLVD, STE. B, NEW ORLEANS, LA 70127-5483
(504) 512-2206
Mailing address
3723 DELAWARE AVE, KENNER, LA 70065-3025
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
06/29/2011
Last updated
06/29/2011
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