| NPI | 1366696098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH CRANOR President/Authorized Official 225-665-5149 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2013-06-10 |