| NPI | 1164997680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK FLOYD GUARISCO COO 225-644-6767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QX0100X Clinic/Center Occupational Medicine | |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2019-10-04 |