NPI | 1104297720 |
---|---|
Entity Type | Organization |
Authorized Contact | STELLA GRACE IMMANUEL Owner 318-221-0277 |
Organization Subpart ? | No |
Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: LA MD12866R) |
Enumeration Date | 2015-10-08 |
Last Update Date | 2015-11-03 |