| NPI | 1366878076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONE ELLIOTT Owner 225-384-5378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: LA 025912) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2023-04-10 |