SOUTHERN PEDIATRIC CLINIC

SHREVEPORT, LA
NPI1104297720
Entity TypeOrganization
Authorized ContactSTELLA GRACE IMMANUEL
Owner
318-221-0277
Organization Subpart ?No
Primary Taxonomy261QH0100X Clinic/Center, Health Services
(Licence: LA  MD12866R)
Enumeration Date2015-10-08
Last Update Date2015-11-03
Business Address
SOUTHERN PEDIATRIC CLINIC
202 N THOMAS DR SUITE 1
SHREVEPORT, LA 71107-6539
Phone number: 318-221-0277
Mailing Address
SOUTHERN PEDIATRIC CLINIC
202 N THOMAS DR SUITE 1
SHREVEPORT, LA 71107-6539
Phone number: 318-221-0277