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1225082746
WK TRI-STATE MEDICAL CLINIC
SHREVEPORT, LA
NPI
1225082746
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Entity Type
Organization
Authorized Contact
GREG J. GAVIN
Network Administrator
318-212-4571
Organization Subpart ?
No
Primary Taxonomy
207R00000X Internal Medicine
Enumeration Date
2006-05-20
Last Update Date
2012-10-05
Business Address
WK TRI-STATE MEDICAL CLINIC
2551 GREENWOOD RD SUITE 410
SHREVEPORT, LA 71103-3981
Phone number: 318-621-2929
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Mailing Address
WK TRI-STATE MEDICAL CLINIC
2551 GREENWOOD RD SUITE 410
SHREVEPORT, LA 71103-3981
Phone number: 318-621-2929
Copy
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