| NPI | 1669772786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA C STEWART Owner 225-926-1495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA 011357) |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2010-10-22 |