Our Lady of Lake Ascension, LLC

NPI #1114201399 in Gonzales, Louisiana

Provider Information

NPI Number
1114201399
Entity Type
Organization
Organization Name
Our Lady of Lake Ascension, LLC
Primary Specialty
Health Educator
Enumeration Date
Oct 5, 2011
Last Updated
Oct 5, 2011

Practice Location

Address
2647 S SAINT ELIZABETH BLVD
ZIP Code
70737-5021
Phone
(225) 647-8511

Authorized Official

Name
JOHN FREDERICK FRAICHE, M.D.
Title
PRESIDENT
Phone
(225) 647-8511

Specialties & Taxonomy Codes

Specialty
Health Educator

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