| NPI | 1508850413 |
|---|---|
| Former Legal Business Name | GWEN MCINNIS ADMINISTRATOR |
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN MORVANT MCINNIS Administrator 504-349-6017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2020-08-22 |