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 |