| NPI | 1225581507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBA WEYMOUTH Owner 985-893-6073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP04133) |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2016-08-03 |