| NPI | 1063432524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLGA E REAVILL Owner 337-264-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: LA 07184R) |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain (Licence: LA 07184R) |
| 261QX0100X Clinic/Center, Occupational Medicine (Licence: LA 07184R) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-08-22 |