| NPI | 1114586344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FALANDA SCOTT RATLIFF Clinic Manager 318-357-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2024-02-29 |