| NPI | 1881641405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI WIDCAMP Manager 337-477-9019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: LA 016824) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2013-04-25 |