| NPI | 1316604762 |
|---|---|
| Doing Business As | THIBODAUX REGIONAL WELLNESS CLINIC |
| Entity Type | Organization |
| Authorized Contact | KIM LEGENDRE BOUDREAUX Contract Manager 985-493-4907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2021-11-19 |
| Last Update Date | 2023-09-05 |