| NPI | 1275075129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDER PUCKETT Office Manager 318-675-1313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA AP08906) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2016-11-09 |