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1477219673
GRACYN LEE GORMAN
SHREVEPORT, LA
NPI
1477219673
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: LA 329002)
Enumeration Date
2021-11-11
Last Update Date
2024-08-24
Business Address
Miss GRACYN LEE GORMAN PA
2709 MACKEY LN
SHREVEPORT, LA 71118-2556
Phone number: 318-671-1131
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Mailing Address
Miss GRACYN LEE GORMAN PA
2709 MACKEY LN
SHREVEPORT, LA 71118-2556
Phone number: 318-671-1131
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