Provider Demographics
NPI:1538625207
Name:LAWORX OF LA, LLC
Entity type:Organization
Organization Name:LAWORX OF LA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:STILWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-705-0880
Mailing Address - Street 1:409 W 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-3011
Mailing Address - Country:US
Mailing Address - Phone:985-705-0880
Mailing Address - Fax:985-888-1742
Practice Address - Street 1:659 BROWNSWITCH RD
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-1233
Practice Address - Country:US
Practice Address - Phone:985-888-1741
Practice Address - Fax:985-888-1742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory