Provider Demographics
NPI:1023399888
Name:T & T KLICK, LLC
Entity Type:Organization
Organization Name:T & T KLICK, LLC
Other - Org Name:FAMILY CARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:KLICK
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:318-248-4100
Mailing Address - Street 1:107 LELA ST
Mailing Address - Street 2:
Mailing Address - City:MANGHAM
Mailing Address - State:LA
Mailing Address - Zip Code:71259-5063
Mailing Address - Country:US
Mailing Address - Phone:318-248-4100
Mailing Address - Fax:318-248-4103
Practice Address - Street 1:107 LELA ST
Practice Address - Street 2:
Practice Address - City:MANGHAM
Practice Address - State:LA
Practice Address - Zip Code:71259-5063
Practice Address - Country:US
Practice Address - Phone:318-248-4100
Practice Address - Fax:318-248-4103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-06
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAPO6543261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care