| NPI | 1093848657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN A LEBEAN Owner 337-261-0559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: LA L022124) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2021-10-29 |