| NPI | 1316970916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KANDI R MOORE Administrator 318-631-2525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: LA 80) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2008-03-31 |