| NPI | 1932397882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYKUTTY J THOMAS Owner 225-757-6031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA 022386) |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2007-10-04 |