| NPI | 1881125664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN M WAGUESPACK Diagnostic Medical Sonographer 225-978-4909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: LA 261qh0100x) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2017-03-23 |