| NPI | 1093996969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BARRETT Administrator 318-728-4181 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health (Licence: LA 211) |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2017-08-18 |