| NPI | 1710078449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN ALLAN HEISE President 225-926-4780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: LA 12387R) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-08-22 |