| NPI | 1457488926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BENNETT Fnp 318-728-3468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health (Licence: LA 141) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2009-02-09 |