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1063769255
WK TOTS TO TEENS PEDIATRIC CENTER
SHREVEPORT, LA
NPI
1063769255
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Entity Type
Organization
Authorized Contact
GREG J GAVIN
Network Administrator
318-212-4232
Organization Subpart ?
No
Primary Taxonomy
208000000X Pediatrics
Enumeration Date
2012-08-07
Last Update Date
2012-08-07
Business Address
WK TOTS TO TEENS PEDIATRIC CENTER
845 OLIVE ST SUITE A
SHREVEPORT, LA 71104-2141
Phone number: 318-226-4892
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Mailing Address
WK TOTS TO TEENS PEDIATRIC CENTER
845 OLIVE ST SUITE A
SHREVEPORT, LA 71104-2141
Phone number: 318-226-4892
Copy
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