| NPI | 1215312996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDA CAROL HIRCHAK Nurse Practitioner 318-730-2336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2015-07-23 |