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 |