| NPI | 1659535847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY M BLAPPERT Owner / Operator 337-984-1124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: LA 2022254) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2009-04-20 |