| NPI | 1316266943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MATTHEW RAINEY Member 318-441-8309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA GETP.200094) |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2010-05-21 |