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1366163214
JOHN NIKKO GABUYA MANGAOANG
SHREVEPORT, LA
NPI
1366163214
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: LA 11349)
Enumeration Date
2022-09-08
Last Update Date
2022-09-08
Business Address
JOHN NIKKO GABUYA MANGAOANG DPT
670 ALBEMARLE DR STE 1100
SHREVEPORT, LA 71106-5945
Phone number: 318-828-1450
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Mailing Address
JOHN NIKKO GABUYA MANGAOANG DPT
670 ALBEMARLE DR STE 1100
SHREVEPORT, LA 71106-5945
Phone number: 318-828-1450
Copy
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