| NPI | 1417098385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN BANG V. NGUYEN Owner 318-424-3268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: LA 09699R) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2007-08-24 |