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1194723577
DALE CARLTON FAZIO
SHREVEPORT, LA
NPI
1194723577
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
213E00000X Podiatrist
(Licence: LA PD009)
Enumeration Date
2005-07-11
Last Update Date
2007-07-08
Business Address
Dr. DALE CARLTON FAZIO D.P.M.
1914 E 70TH ST SUITE D
SHREVEPORT, LA 71105-5312
Phone number: 318-797-3470
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Mailing Address
Dr. DALE CARLTON FAZIO D.P.M.
1914 E 70TH ST SUITE D
SHREVEPORT, LA 71105-5312
Phone number: 318-797-3470
Copy
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