| NPI | 1063698462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASY L MIRE Office Manager 337-266-9985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: LA BC201667) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2023-02-17 |