| NPI | 1164667887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN W MCCLURE Owner 318-253-7509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: LA MD.09293R) |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2008-12-09 |