| NPI | 1649002734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER STOUT Manager 337-315-7927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2024-08-16 |
| Last Update Date | 2024-08-16 |