| NPI | 1356722466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE MERRIMAN Owner 318-222-3132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: LA PA.200749) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2016-07-27 |