| NPI | 1679710420 |
|---|---|
| Former Legal Business Name | MAXX MEDICAL CORPORATION |
| Entity Type | Organization |
| Authorized Contact | CHERILYNNE T. COTTLES Owner/Physician 318-238-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: LA 16920) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: LA 16920) |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2009-01-15 |