Organization
INDEPENDENCE FAMILY CLINIC LLC
Active
Other names
Independence Family Clinic LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN DALE TATE JR. FNP (MANAGER)
(985) 878-4183
Entity
Organization
Contact information
Practice address
312 E RAILROAD AVE, INDEPENDENCE, LA 70443-2710
(985) 878-4183
Mailing address
312 E RAILROAD AVE, INDEPENDENCE, LA 70443-2710
(985) 878-4183
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/19/2023
Last updated
04/23/2025
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