| NPI | 1326466954 |
|---|---|
| Doing Business As | LOUISIANA COLLEGE SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MICHAEL PATRICK BERRY Billing Service Manager 314-598-1663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2021-02-26 |