| NPI | 1053979815 |
|---|---|
| Doing Business As | BOGALUSA PEDIATRIC CLINIC |
| Entity Type | Organization |
| Authorized Contact | ANTHONY JUDE PALAZZO CEO 985-732-1568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2019-06-05 |