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1023047149
SUSAN MICHELLE SELF
SHREVEPORT, LA
NPI
1023047149
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: LA 023219)
Enumeration Date
2006-07-01
Last Update Date
2007-12-18
Business Address
-- SUSAN MICHELLE SELF MD
8001 YOUREE DR SUITE 540
SHREVEPORT, LA 71115-2302
Phone number: 318-212-3810
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Mailing Address
-- SUSAN MICHELLE SELF MD
8001 YOUREE DR SUITE 540
SHREVEPORT, LA 71115-2302
Phone number: 318-212-3810
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