NPI | 1346755154 |
---|---|
Entity Type | Organization |
Authorized Contact | DUSTIN JOSEPH MILLER President 337-447-4027 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: LA 2203783812) |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2017-12-04 |
Last Update Date | 2018-06-19 |