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1003139619
VA DIABETIC FOOT SOURCE LLC
SHREVEPORT, LA
NPI
1003139619
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Entity Type
Organization
Authorized Contact
VICTOR V MANNING
Owner
318-560-2700
Organization Subpart ?
No
Primary Taxonomy
251J00000X Nursing Care
(Licence: LA RN121799)
Enumeration Date
2010-03-10
Last Update Date
2010-03-10
Business Address
VA DIABETIC FOOT SOURCE LLC
9414 ASHMONT ST
SHREVEPORT, LA 71129-4830
Phone number: 318-560-2700
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Mailing Address
VA DIABETIC FOOT SOURCE LLC
9414 ASHMONT ST
SHREVEPORT, LA 71129-4830
Phone number: 318-560-2700
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