| NPI | 1013552884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET L JUSTICE Director Of Operations 318-807-7875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2019-11-15 |