| NPI | 1578518866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIKI M BROUSSARD Billing Contract Manager 337-237-3424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2011-05-24 |