| NPI | 1548002942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J HEBERT Practice Manager 318-229-5055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2024-06-07 |
| Last Update Date | 2024-07-11 |