| NPI | 1710253836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN G FASICK Manager 504-301-1749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: LA DPM.PD284R) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2012-03-23 |