| NPI | 1023775475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE HOLMES Managing Employee 337-962-2488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine |
| Additional Taxonomies | 261QI0500X Clinic/Center Infusion Therapy |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2021-11-19 |
| Last Update Date | 2022-08-03 |