| NPI | 1033381520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA CANOY SHORE Office Manager 318-325-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: LA MD.021601) |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2023-06-30 |