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1366900425
CANDICE STALLONE TYREE
SHREVEPORT, LA
NPI
1366900425
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
343900000X Non-emergency Medical Transport (VAN)
Enumeration Date
2019-03-07
Last Update Date
2019-03-07
Business Address
CANDICE STALLONE TYREE
6604 JEFFERSON PAIGE RD
SHREVEPORT, LA 71119-5006
Phone number: 318-288-1949
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Mailing Address
CANDICE STALLONE TYREE
6604 JEFFERSON PAIGE RD
SHREVEPORT, LA 71119-5006
Phone number: 318-288-1949
Copy
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