Organization
SOUTH LOUISIANA WELLNESS SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA DUPONT NP (AGENT)
(985) 856-7893
Entity
Organization
Contact information
Practice address
4266 W MAIN ST STE 100, GRAY, LA 70359-6421
(985) 856-7893
(985) 346-6944
Mailing address
4266 W MAIN ST STE 100, GRAY, LA 70359-6421
(985) 856-7893
(985) 346-6944
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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