THEODORE DALLAS

SHREVEPORT, LA
NPI1316425440
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2018-07-31
Last Update Date2018-07-31
Business Address
THEODORE DALLAS
1543 GRIMMETT DR
SHREVEPORT, LA 71107-6505
Phone number: 318-626-5597
Mailing Address
THEODORE DALLAS
1543 GRIMMETT DR
SHREVEPORT, LA 71107-6505
Phone number: 318-626-5597
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