NPI | 1407964349 |
---|---|
Entity Type | Organization |
Authorized Contact | CHARLES EDWARD FONTENOT President 337-363-5521 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD010529) |
Enumeration Date | 2006-08-29 |
Last Update Date | 2020-08-22 |