| NPI | 1215067905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT PAUL GOUX Owner 318-253-7511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA MD201185) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |