| NPI | 1134233414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTA CRAMER Administrator 225-906-2570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: LA 102) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-08-22 |