| NPI | 1124565296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD WARREN PRATT Owner 337-989-8080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2017-01-26 |