| NPI | 1700058179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK EDWARD CLAWSON President 337-824-8099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: LA 020456) |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2008-03-26 |