| NPI | 1912311812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIMEE B. FERRELL Owner 225-367-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: LA 261QM2500X) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-08-25 |