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1124108758
PHILLIP M PRIDDY
SHREVEPORT, LA
NPI
1124108758
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: LA RN054704)
Enumeration Date
2006-10-17
Last Update Date
2015-04-23
Business Address
-- PHILLIP M PRIDDY CRNA
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-675-5584
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Mailing Address
-- PHILLIP M PRIDDY CRNA
1501 KINGS HWY
SHREVEPORT, LA 71130-4228
Phone number: 318-675-5584
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