| NPI | 1083156632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA J. HOLSTEAD Office Manager 318-324-0111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA 12124R) |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2016-11-14 |