| NPI | 1720505134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE A GALLOWAY President 985-726-9605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2017-08-25 |