NPI | 1700085594 |
---|---|
Entity Type | Organization |
Authorized Contact | PATSY D JOHNSON Accounting Director 318-671-8131 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA PCA10802) |
Enumeration Date | 2007-07-12 |
Last Update Date | 2007-07-12 |