Organization
BALLET MEDICAL CORPORATION
Active
Other names
CORPORATION
Organization subpart
No
Provider details
NPI number
Authorized official
MISS OCTAVIA J TAYLOR (PRESIDENT)
(318) 388-2022
Entity
Organization
Contact information
Practice address
806 N 31ST ST, # D, MONROE, LA 71201-3945
(318) 388-2022
(318) 388-2023
Mailing address
806 N 31ST ST, # D, MONROE, LA 71201-3945
(318) 388-2022
(318) 388-2023
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
5196449-001
LA
Other
Enumeration date
07/20/2007
Last updated
07/20/2007
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