| NPI | 1073693958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANIA ANN LEVI Owner 985-809-6195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA 018251) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2010-08-16 |