| NPI | 1215242045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK BOURQUE President/CEO 225-744-3902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: LA 1108) |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2010-08-17 |