Organization
LTP MEDICAL MOBILE, INC.
Active
Other names
The Health Hut
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACKIE K WHITE M.D. (MEDICAL DIRECTOR)
(318) 513-1212
Entity
Organization
Contact information
Practice address
310 WEST MISSISSIPPI AVE., RUSTON, LA 71270-9541
(318) 513-1212
(318) 513-7673
Mailing address
310 WEST MISSISSIPPI AVE., RUSTON, LA 71270-9541
(318) 513-1212
(318) 513-7673
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2428438
—
LA
Enumeration date
06/05/2011
Last updated
03/31/2017
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