| NPI | 1376054726 |
|---|---|
| Doing Business As | INTERVENTIONAL SPINE AND REHABILITATION OF LOUISIANA |
| Entity Type | Organization |
| Authorized Contact | MACKENZIE HAHN Ncpdp Coordinator 479-636-9702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: LA MD202152) |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2017-11-15 |