NPI | 1326387705 |
---|---|
Entity Type | Organization |
Authorized Contact | DARRELL L KINGHAM CFO 337-462-7409 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
Enumeration Date | 2013-02-05 |
Last Update Date | 2020-11-25 |