| NPI | 1699177345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY MAXINE MCCRARY Owner 225-505-5217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA AP07509) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2014-09-24 |