| NPI | 1154456507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL M PARKER Office Administrator 337-491-9880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: LA AS3413135) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2009-07-09 |