| NPI | 1760598726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACONDRA HUNTER Office Administrator 318-473-9267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2018-05-22 |