| NPI | 1487185955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT PAUL GUILBAULT Owner/Proprietor 985-630-9618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA 12621-R) |
| Enumeration Date | 2017-03-25 |
| Last Update Date | 2018-03-21 |