| NPI | 1295180453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY NICOLE PETRUS Owner 318-372-9732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech (Licence: LA 5768) |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2016-04-25 |