NPI | 1386238525 |
---|---|
Entity Type | Organization |
Authorized Contact | LINDSEY MARLOWE RODGERS Owner 318-562-3911 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 208D00000X General Practice |
261QM1300X Clinic/Center, Multi-Specialty | |
Enumeration Date | 2021-02-28 |
Last Update Date | 2024-10-23 |