| NPI | 1700181997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA T LEVRON Clinic Administrator 985-868-1810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: LA 12026) |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2011-01-19 |