| NPI | 1376657817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS CHARLES DANSBY Owner 318-322-7836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: LA MD020461) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2017-10-18 |