| NPI | 1821379223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT JOHN TILLEY Owner 504-974-6170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR 14698) |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2014-03-27 |