| NPI | 1992122642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID P ALLEN Owner 985-215-5618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: LA DPM.200052) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2014-03-19 |