NPI | 1124149307 |
---|---|
Entity Type | Organization |
Authorized Contact | GARLAND DUPREE MILLER President 318-645-4484 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA 16359) |
Enumeration Date | 2007-04-03 |
Last Update Date | 2020-08-22 |