| NPI | 1851882997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS FALLIN Billing Manager 225-532-4064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2018-05-24 |