| NPI | 1184708661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT DOUGLAS HAYDEL Officer/Director 985-868-7566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: LA 019894) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2008-03-06 |