| NPI | 1457531089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE ANTOINETTE PITTMAN Owner 318-675-1322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: LA 201400) |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2012-01-09 |