NPI | 1306233572 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM BRADFORD MCCORMICK CFO 318-214-4350 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA 000000) |
Enumeration Date | 2015-04-24 |
Last Update Date | 2020-06-26 |