| NPI | 1205289873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDDIE ANN CHANDLER Owner 337-439-3344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA 00207) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2016-07-19 |