| NPI | 1710004007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONELLE W COUCH Business Office Manager 504-887-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: LA 015206) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: LA 015206) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |