| NPI | 1134329451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MARIAN WITOSZKA Physician 318-473-0010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: RI MD05460) |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2007-07-24 |