| NPI | 1538446794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACEY MILLETT CAVANAUGH Owner 337-527-7087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA 203896) |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2011-11-15 |