Organization
EXTREMITY CMA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CHENILE TEZENO (OWNER)
(337) 363-1237
Entity
Organization
Contact information
Practice address
2878 TATE COVE RD, VILLE PLATTE, LA 70586-6311
(337) 363-1237
(337) 363-1384
Mailing address
2878 TATE COVE RD, VILLE PLATTE, LA 70586-6311
(337) 363-1237
(337) 363-1384
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
CM 27068
LA
Other
Enumeration date
04/05/2013
Last updated
04/05/2013
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