| NPI | 1750638391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI ANN CORMIER-MIRE Office Manager 337-534-4410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2023-01-04 |