| NPI | 1699055475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEAU J BAGLEY Owner 504-237-1430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: LA 14743R) |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2013-03-30 |