| NPI | 1962121855 |
|---|---|
| Former Legal Business Name | GIDDY UP PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | AMBER C. CHANLER Owner 318-372-8797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2023-05-25 |