Organization
BLUE BAYOU SERVICES GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH J MANAS (CEO)
(504) 339-2302
Entity
Organization
Contact information
Practice address
6221 S CLAIBORNE AVE, STE B614, NEW ORLEANS, LA 70125-4142
(504) 339-2302
Mailing address
6221 S CLAIBORNE AVE, STE B614, NEW ORLEANS, LA 70125-4142
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
06583R
LA
Other
Enumeration date
02/16/2010
Last updated
02/16/2010
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