| NPI | 1558485235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE DARRELL ELLENDER President 337-594-8958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 024917) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2017-03-13 |