Organization
ADVANCED THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUDOLPH CASANOVA CLARKE (OWNER)
(504) 621-2306
Entity
Organization
Contact information
Practice address
1799 STUMPF BLVD BLDG 3, TERRYTOWN, LA 70056-3950
(504) 407-0755
(504) 407-0778
Mailing address
1799 STUMPF BLVD BLDG 3, TERRYTOWN, LA 70056-3950
(504) 407-0755
(504) 407-0778
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
305R00000X
LA
Other
Enumeration date
12/18/2014
Last updated
12/18/2014
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