| NPI | 1861657421 |
|---|---|
| Doing Business As | SOUTHEAST PROFESSIONAL HEALTH GROUP LLC |
| Entity Type | Organization |
| Authorized Contact | THANE BATTISTE PAINIA Manager 225-687-9902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: LA 194709) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2008-08-08 |