| NPI | 1669524161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES EDWARD JACKSON President 318-220-7334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA PT01438) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-08-22 |