| NPI | 1326395997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA RICHARD Assistant Administrator 337-312-8291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 213E00000X Podiatrist | |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2017-01-16 |