| NPI | 1962969352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONELL WILLIAMS Contract Administrator 504-495-2727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine |
| 261Q00000X Clinic/Center | |
| 261QP2300X Clinic/Center Primary Care | |
| 261QP3300X Clinic/Center Pain | |
| 261QX0100X Clinic/Center Occupational Medicine | |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2019-02-21 |