NPI | 1255010617 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMIE AVERETT KLUMPP Owner 337-476-5071 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
Enumeration Date | 2023-07-13 |
Last Update Date | 2023-07-13 |