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1245785237
FERNANDEZ A GRAHAM
SHREVEPORT, LA
NPI
1245785237
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2016-08-18
Last Update Date
2016-08-18
Business Address
Mr. FERNANDEZ A GRAHAM
3610 LAKESIDE DR
SHREVEPORT, LA 71119-6516
Phone number: 318-560-3002
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Mailing Address
Mr. FERNANDEZ A GRAHAM
3610 LAKESIDE DR
SHREVEPORT, LA 71119-6516
Phone number: 318-560-3002
Copy
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