| NPI | 1811277205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MICHAEL MCGINITY Owner 318-448-7063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: LA 020633) |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2011-08-17 |