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1669929667
KENYATTA TILLMAN
BOSSIER CITY, LA
NPI
1669929667
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2016-09-07
Last Update Date
2019-05-29
Business Address
KENYATTA TILLMAN
3018 OLD MINDEN RD STE 1117
BOSSIER CITY, LA 71112-2497
Phone number: 318-746-1935
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Mailing Address
KENYATTA TILLMAN
3018 OLD MINDEN RD STE 1117
BOSSIER CITY, LA 71112-2497
Phone number: 318-746-1935
Copy
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