NPI | 1558683615 |
---|---|
Entity Type | Organization |
Authorized Contact | CURTIS A EDWARDS Clinical Director 318-238-3773 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service (Licence: LA 451) |
Enumeration Date | 2010-02-17 |
Last Update Date | 2010-02-17 |