NPI | 1003430257 |
---|---|
Doing Business As | THIBODAUX REGIONAL PLASTIC & RECONSTRUCTIVE SURGERY CLINIC |
Entity Type | Organization |
Authorized Contact | KIM LEGENDRE BOUDREAUX Contract Manager 985-493-4907 |
Organization Subpart ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
Enumeration Date | 2020-06-03 |
Last Update Date | 2023-08-21 |