| NPI | 1205036274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA P BURDEAUX Owner 318-396-6807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA APO4819) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2009-08-17 |