| NPI | 1922591080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA ANDERSON PRUITT Nurse Practitioner 225-284-7158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2019-11-11 |