| NPI | 1740624139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENDA P DOBSON VP, Clinical Services 985-690-7502 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 1043996) |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2013-04-29 |