| NPI | 1558507632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JADE NICHOLAS HEINEN President 337-457-8166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.201684) |
| Enumeration Date | 2008-12-19 |
| Last Update Date | 2008-12-19 |