NPI | 1144491614 |
---|---|
Entity Type | Organization |
Authorized Contact | JANNA L CRUEY Administrator 318-212-0552 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: LA 164) |
Enumeration Date | 2008-03-12 |
Last Update Date | 2010-05-14 |