Organization
AFFINITY HEALTH GROUP, LLC
Active
Other names
Affinity Family Practice & Wound Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE BREARD (VICE PRESIDENT)
(318) 361-0900
Entity
Organization
Contact information
Practice address
920 OLIVER RD # J, MONROE, LA 71201-5702
(318) 807-3700
(318) 807-0014
Mailing address
130 DESIARD ST, STE 355, MONROE, LA 71201-7319
(318) 807-7875
(318) 812-6603
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Enumeration date
06/17/2011
Last updated
05/28/2020
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