| NPI | 1578885240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS RUBEN VAZQUEZ Owner 225-647-1947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA 022083) |
| Enumeration Date | 2010-02-23 |
| Last Update Date | 2010-02-23 |