| NPI | 1780814756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRELL L KINGHAM CFO 337-462-7111 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA MD.09850R) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2017-04-13 |