Organization
ALLEN'S FAMILY PRACTICE CLINIC OF PONCHATOULA, L.L.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATHY L. ALLEN (CLINIC MANAGER)
(985) 386-6198
Entity
Organization
Contact information
Practice address
105 E OAK ST, PONCHATOULA, LA 70454-2619
(985) 386-6198
(985) 386-6223
Mailing address
PO BOX 129, PONCHATOULA, LA 70454-0129
(985) 386-6198
(985) 386-6223
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1950009
—
LA
Enumeration date
10/12/2005
Last updated
01/07/2010
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