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 |