Organization
KISATCHIE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WENDY CHRISTINA GODEAUX (OFFICE MANAGER)
(318) 473-1921
Entity
Organization
Contact information
Practice address
3425 NORTH BLVD STE A, ALEXANDRIA, LA 71301-3608
(318) 473-1921
(318) 473-1922
Mailing address
3425 NORTH BLVD STE A, ALEXANDRIA, LA 71301-3608
(318) 473-1921
(318) 473-1922
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/19/2010
Last updated
11/19/2010
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