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1093469108
MICAH GUILLORY
SHREVEPORT, LA
NPI
1093469108
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2022-02-08
Last Update Date
2022-02-08
Business Address
MICAH GUILLORY
9403 MANSFIELD RD
SHREVEPORT, LA 71118-3815
Phone number: 318-861-8938
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Mailing Address
MICAH GUILLORY
9403 MANSFIELD RD
SHREVEPORT, LA 71118-3815
Phone number: 318-861-8938
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