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1407882178
MELANIE C FREDERICK
SHREVEPORT, LA
NPI
1407882178
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Entity Type
Organization
Authorized Contact
GREG J. GAVIN
Network Administrator
318-687-5277
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
Enumeration Date
2006-06-24
Last Update Date
2020-08-22
Business Address
MELANIE C FREDERICK
2508 BERT KOUNS LOOP SUITE 103
SHREVEPORT, LA 71118-3133
Phone number: 318-687-5277
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Mailing Address
MELANIE C FREDERICK
2508 BERT KOUNS LOOP SUITE 103
SHREVEPORT, LA 71118-3133
Phone number: 318-687-5277
Copy
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