| NPI | 1528157914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDMOND JUDE RESTIVO Prosthetist/Orthotist 985-726-9052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: AL CPO02238) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |