NPI | 1437285442 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHNNY COX Executive Director 318-932-3177 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA 10793) |
Enumeration Date | 2007-02-26 |
Last Update Date | 2007-09-11 |