| NPI | 1801077672 |
|---|---|
| Doing Business As | MCLOUTH MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | AMY C MILLER Cred Spec 985-505-2988 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 364SF0001X Clinical Nurse Specialist, Family Health (Licence: KS 13-59692-09) |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2014-04-25 |