NPI | 1659720506 |
---|---|
Entity Type | Organization |
Authorized Contact | KERNEY THOMAS CEO 337-363-4521 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA HC0006113) |
Enumeration Date | 2016-06-10 |
Last Update Date | 2016-06-10 |