NPI | 1528808268 |
---|---|
Entity Type | Organization |
Authorized Contact | TYLER STOUT Manager 337-315-7927 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
363L00000X Nurse Practitioner | |
Enumeration Date | 2024-05-30 |
Last Update Date | 2024-05-30 |