| NPI | 1083617237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIGUEL A CULASSO Owner/Physician 985-646-0945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 013032) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2011-04-05 |