| NPI | 1699956268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERTRAND ANTOINE President 662-345-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MS 00437897) |
| Enumeration Date | 2007-11-23 |
| Last Update Date | 2008-05-13 |