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BOSSIER CITY, LA
NPI1124764964
Entity TypeOrganization
Authorized ContactTIA DESHAUN THOMAS
Owner
318-317-1238
Organization Subpart ?No
Primary Taxonomy363L00000X Nurse Practitioner
Enumeration Date2022-05-05
Last Update Date2023-07-06
Business Address
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1701 OLD MINDEN RD STE 17F
BOSSIER CITY, LA 71111-4804
Phone number: 318-317-1238
Mailing Address
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1701 OLD MINDEN RD STE 17F
BOSSIER CITY, LA 71111-4804
Phone number: 318-317-1238