| NPI | 1952264673 |
|---|---|
| Other Name | FRED JEFFERSON LINER JR. |
| Entity Type | Organization |
| Authorized Contact | FRED JEFFERSON LINER Owner/Manager 985-320-2474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Enumeration Date | 2025-12-09 |
| Last Update Date | 2025-12-09 |