| NPI | 1548440811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA NATALIE BLAKE-MCMAHON CEO 318-741-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: LA 14851R) |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2012-01-20 |