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Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adult Medicine |
207QA0505X | 08 | Physician/Family Practice | |
Family Medicine |
207Q00000X | 08 | Physician/Family Practice |
| NPI Number | 1356830251 |
| LBN Legal business name | METAIRIE TOTAL WELLNESS CLINIC, LLC |
| Authorized official | SALVATORE CAMPO - (DO / PHYSICIAN) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | 05/07/2018 |
| Last updated | 05/07/2018 - About 8 years ago |
| Identifiers | n/a |
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