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1164762191
BRIAN C PRIMEAUX
SHREVEPORT, LA
NPI
1164762191
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: LA 46416)
Enumeration Date
2013-02-28
Last Update Date
2013-05-27
Business Address
-- BRIAN C PRIMEAUX
5610 BUNCOMBE RD APT. 1011
SHREVEPORT, LA 71129-2697
Phone number: 337-852-6386
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Mailing Address
-- BRIAN C PRIMEAUX
5610 BUNCOMBE RD APT. 1011
SHREVEPORT, LA 71129-2697
Phone number: 337-852-6386
Copy
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