Organization · NPI-2

Fine Lines Cosmetic Laser Cnt

Clinic/Center · Crowley, LA

NPI number1609077676
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1609077676
Entity type
Organization (NPI-2)
Legal business name
Fine Lines Cosmetic Laser Cnt
Organization subpart
No
Enumeration date
May 29, 2007
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center–LAYes

Practice location

717 N Eastern Ave
Crowley, LA 70526-3856

Phone 337-783-2426 · Fax 337-783-2483

Mailing address

717 N Eastern Ave
Crowley, LA 70526-3856

Phone 337-783-2426 · Fax 337-783-2483

Authorized official

Bronwen B Darbonne
President
3377832426

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