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1225417942
SHANNON KOVELESKIE
SHREVEPORT, LA
NPI
1225417942
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: LA PA.200784)
Enumeration Date
2015-05-27
Last Update Date
2015-05-27
Business Address
-- SHANNON KOVELESKIE
1860 FAIRFIELD AVE
SHREVEPORT, LA 71101-4431
Phone number: 318-675-1313
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Mailing Address
-- SHANNON KOVELESKIE
1860 FAIRFIELD AVE
SHREVEPORT, LA 71101-4431
Phone number: 318-675-1313
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