| NPI | 1902095987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMIKA MAYO Medical Doctor 225-381-2712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA 023611) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2011-05-24 |