Organization
MARINE MEDICAL CONSULTANTS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE MARTIN ENNIS M.D. (OWNER)
(985) 200-3530
Entity
Organization
Contact information
Practice address
675 NORTH CAUSEWAY BLVD, MANDEVILLE, LA 70448-4600
(985) 200-3530
Mailing address
675 N CAUSEWAY BLVD, MANDEVILLE, LA 70448-4600
(985) 200-3530
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
201758
LA
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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