| NPI | 1679620603 |
|---|---|
| Other Name | MANUEL MEDICAL CLINIC, INC. SITE 002 |
| Entity Type | Organization |
| Authorized Contact | POWLIN V MANUEL President 337-984-0110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207K00000X Allergy & Immunology |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA AP05389) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA AP07960) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-04-21 |