Organization
CHAIR MRI OF LOUISIANA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER BRUCE GERVAIS (OWNER/MANAGER)
(985) 893-4222
Entity
Organization
Contact information
Practice address
2639 N CAUSEWAY BLVD, MANDEVILLE, LA 70471-6435
(985) 893-4222
(985) 893-4026
Mailing address
2639 N CAUSEWAY BLVD, MANDEVILLE, LA 70471-6435
(985) 893-4222
(985) 893-4026
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
40873367K
LA
Other
Enumeration date
11/11/2013
Last updated
04/23/2014
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