| NPI | 1184179079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL BARTEL FORESTER Member, Secretary 318-641-0865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD06029R) |
| Enumeration Date | 2016-08-20 |
| Last Update Date | 2016-08-20 |