NPI | 1801831169 |
---|---|
Entity Type | Organization |
Authorized Contact | GREG J. GAVIN Network Administrator 318-932-2170 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2006-06-19 |
Last Update Date | 2012-06-08 |