| NPI | 1659300739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN L LEDBETTER Phyician Owner 318-323-6405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2011-05-25 |