| NPI | 1568273605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL PARKER Owner 225-284-7336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2025-01-17 |
| Last Update Date | 2025-08-19 |