NPI | 1689791915 |
---|---|
Entity Type | Organization |
Authorized Contact | DIANN BECKWITH President 318-651-0201 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA PCA 9098) |
Enumeration Date | 2007-03-23 |
Last Update Date | 2008-03-05 |