NPI | 1215372594 |
---|---|
Entity Type | Organization |
Authorized Contact | MARTTHA L COPPAGE Vice President 337-364-2383 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA 022088) |
Enumeration Date | 2013-05-01 |
Last Update Date | 2013-05-06 |