| NPI | 1598701583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK D. MOORE Medical Director 337-948-6331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD024344) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| 332900000X Non-Pharmacy Dispensing Site | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2015-02-16 |