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1376115212
DALTON ROBERT CARROLL
SHREVEPORT, LA
NPI
1376115212
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: LA 220441)
Enumeration Date
2021-07-12
Last Update Date
2021-07-12
Business Address
DALTON ROBERT CARROLL FNP-C
8445 LINE AVE
SHREVEPORT, LA 71106-5925
Phone number: 318-703-5655
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Mailing Address
DALTON ROBERT CARROLL FNP-C
625 DUMAINE DR
BOSSIER CITY, LA 71111-6277
Phone number: 318-751-1246
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