| NPI | 1427174549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNETTE SEPULVADO BERGSTEDT Owner 337-474-2933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: LA MD.021307) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2008-06-26 |