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1366436487
MARY ALEXIS K GREEN
SHREVEPORT, LA
NPI
1366436487
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: LA PA.200024)
Enumeration Date
2005-09-02
Last Update Date
2020-12-11
Business Address
MARY ALEXIS K GREEN PA-C
1455 E BERT KOUNS LOOP
SHREVEPORT, LA 71105-5634
Phone number: 318-798-4623
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Mailing Address
MARY ALEXIS K GREEN PA-C
1455 E BERT KOUNS LOOP
SHREVEPORT, LA 71105-5634
Phone number: 318-798-4623
Copy
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