| NPI | 1710425574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORINE HARDMAN BOWMAN Sole Owner 318-464-8073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 023946) |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2017-04-05 |