| NPI | 1477674083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES K CHAMPAGNE Practice Administrator 985-857-8093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085N0904X |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging |
| 2085R0202X Radiology, Diagnostic Radiology | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2025-09-11 |