Organization
PEDIATRIC AND ADOLESCENT MEDICINE SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID VAN GELDER (OWNER)
(225) 252-6520
Entity
Organization
Contact information
Practice address
1213 N RANGE AVE, DENHAM SPRINGS, LA 70726-2411
(225) 933-0090
Mailing address
1213 N RANGE AVE, DENHAM SPRINGS, LA 70726-2411
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
02/19/2020
Last updated
02/19/2020
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