| NPI | 1174681647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY O CORLEY Office Manager 318-253-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA 023281) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2014-04-03 |