| NPI | 1265437743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS E PALMER Board Member 318-683-0411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: LA 100) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2022-01-07 |