| NPI | 1164893178 |
|---|---|
| Doing Business As | WHITE CLOVER WELLNESS & RESEARCH CENTER |
| Entity Type | Organization |
| Authorized Contact | TAMARA M SMITH CFO 318-455-8856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2016-01-26 |