| NPI | 1386603173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY HALEY Owner 225-923-0960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: LA 92) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2008-02-12 |