| NPI | 1699429415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE KIMBALL MARTIN Administrator 985-853-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2022-02-10 |