| NPI | 1033512322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY BEAUCOUDRAY Owner/Operator 504-454-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: LA 201074) |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2022-07-21 |