| NPI | 1346502549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HOLCOMBE Medical Administrator 318-628-2148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: LA RN041436) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2012-06-13 |