Organization
ORTHOPAEDIC AND SPORTS MEDICINE SPECIALIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACY L RADA (BILLING SUPERVISOR)
(318) 443-9191
Entity
Organization
Contact information
Practice address
224 PECAN PARK AVE, ALEXANDRIA, LA 71303-3308
(318) 443-9191
(318) 443-4144
Mailing address
224 PECAN PARK AVE, ALEXANDRIA, LA 71303-3308
(318) 443-9191
(318) 443-4144
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Enumeration date
09/26/2006
Last updated
08/22/2020
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