| NPI | 1447485412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICKEY ROSS DUOS Owner 337-349-4836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA ap05285) |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2009-05-20 |