| NPI | 1265752430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JAMES COOGAN Owner 225-975-9045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA MD.012264) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2011-04-26 |