| NPI | 1760616585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER G. BENNETT Owner 318-728-4368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: LA 141) |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2009-08-05 |