Organization
ACCEPTANCE KIDMED OF LA LLC
Active
Organization
ACCEPTANCE KIDMED OF LA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARITA DAVIS ACKLIN (ADMINISTRATOR)
(225) 405-2874
Entity
Organization
Contact information
Practice address
947 N BON MARCHE DR, 107, BATON ROUGE, LA 70806-8833
(225) 405-2874
Mailing address
947 N BON MARCHE DR, 107, BATON ROUGE, LA 70806-8833
(225) 405-2874
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
Primary
—
—
Other
Enumeration date
11/18/2011
Last updated
11/18/2011
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