| NPI | 1750931945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM ORTEGO Owner 337-948-9606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2023-06-01 |