| NPI | 1134328966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS GLEN MIRE Owner 337-981-0305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: LA 012202) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2008-05-21 |