Moss Street Kid Med Llc
Clinic/Center in Lafayette, LA(View on Map)
Legal Business Name
Moss Street Kid Med Llc
NPI Number
1336268184
NPI Type
Organization
Enumeration Date
03/29/2007
Specialties
(Taxonomies)Contact
Information
Purpose
Mailing
Location
Address
1417A MOSS ST
1417A MOSS STREET
City
Lafayette
Lafayette
State
LA
LA
Postal Code
70501-3654
70501
Country
US
US
Telephone Number
(337) 291-2411
(337) 291-2411
Authorized Official
Name
Mrs. Desiree Richard
Title or Position
ONWER
Telephone Number
(337) 291-2411
Identifiers
Identifier
1949221
Identifier State
LA
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 03/25/2009
Provider Address
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