| NPI | 1184033854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID VANDERMOLEN Director 318-841-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0006X Clinic/Center, Ambulatory Fertility Facility |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: LA AP0799) |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2014-08-07 |