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1679510457
LEONARD TERRY MARTIN
SHREVEPORT, LA
NPI
1679510457
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: LA 200825)
Enumeration Date
2006-06-01
Last Update Date
2023-02-27
Business Address
LEONARD TERRY MARTIN PA
1541 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-626-0000
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Mailing Address
LEONARD TERRY MARTIN PA
1512 W KIRBY PL
SHREVEPORT, LA 71103-3822
Phone number: 318-626-0177
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