| NPI | 1053766170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIAH REED Massage Therapist 318-516-9626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: LA LA5986) |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2016-04-26 |