NPI | 1033390786 |
---|---|
Entity Type | Organization |
Authorized Contact | BEATRICE M PARKER Owner 225-767-3099 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: LA pca 14074) |
Enumeration Date | 2007-11-23 |
Last Update Date | 2008-04-08 |