| NPI | 1154503241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS H MCCORMICK Owner 337-828-4440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA 04661r) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: LA 04661R) |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2007-12-03 |