NPI | 1124461082 |
---|---|
Entity Type | Organization |
Authorized Contact | ASHLEA LAUREN HILL Owner 318-224-3044 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP06647) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: LA 2390) |
Enumeration Date | 2013-04-10 |
Last Update Date | 2013-04-10 |