| NPI | 1902287634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY N YALAMANCHILI Vicepresident 225-939-7787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA 11651R) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2015-06-18 |