JENNIE MOORE BANGE

SHREVEPORT, LA
NPI1013193879
Professional NameJENNIE BANGE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225X00000X Occupational Therapist
(Licence: LA  200202)
Enumeration Date2008-01-11
Last Update Date2008-01-28
Business Address
-- JENNIE MOORE BANGE LOTR
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-813-2972
Mailing Address
-- JENNIE MOORE BANGE LOTR
522 OIL FIELD RD
ELM GROVE, LA 71051-7909
Phone number: 318-741-6837
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