Organization
NELA SPORTCENTER, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACOB RANDALL PONDER LOTR (OWNER/MANAGER)
(318) 329-8998
Entity
Organization
Contact information
Practice address
307 REGISTER ST, WEST MONROE, LA 71291-2737
(318) 329-8998
(318) 329-8997
Mailing address
307 REGISTER ST, WEST MONROE, LA 71291-2737
(318) 329-8998
(318) 329-8997
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/01/2007
Last updated
08/01/2007
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