Organization
PEDIATRICS PRIMARY CARE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY COLLINS NURSE PRACTITIONER (OWNER)
(318) 794-2428
Entity
Organization
Contact information
Practice address
11098 HIGHWAY 165 S, FOREST HILL, LA 71430-9789
(318) 368-1236
Mailing address
PO BOX 457, FOREST HILL, LA 71430-0457
(318) 794-2428
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/11/2022
Last updated
01/18/2024
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