| NPI | 1215978309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BRUCE WALLACE Medical Director 318-448-0221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: LA 012846) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2008-07-25 |