| NPI | 1235625252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA MARIE ALLEN CEO 318-617-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: LA 10010142961) |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2018-07-02 |