Organization
EARLY DETECTION SCREENINGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI G OLIVIER (MANAGER)
(337) 331-5995
Entity
Organization
Contact information
Practice address
110 HOSPITAL DR, LAFAYETTE, LA 70503-2819
(337) 232-4150
(337) 232-2990
Mailing address
110 HOSPITAL DR, LAFAYETTE, LA 70503-2819
(337) 232-4150
(337) 232-2990
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
96204
LA
Other
Enumeration date
06/04/2015
Last updated
06/04/2015
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