| NPI | 1093032237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA T LEVRON Clinic Adminstrator 985-868-1810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: KY 11220) |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2010-04-28 |