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1487388385
DIVYA REDDY GAVINI
SHREVEPORT, LA
NPI
1487388385
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-07-15
Last Update Date
2022-07-15
Business Address
DIVYA REDDY GAVINI MD
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-330-7661
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Mailing Address
DIVYA REDDY GAVINI MD
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number:
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