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1689175572
JADETRICK I JAMES
SHREVEPORT, LA
NPI
1689175572
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2018-02-26
Last Update Date
2018-05-21
Business Address
JADETRICK I JAMES
8101 KINGSTON RD STE 101B
SHREVEPORT, LA 71108
Phone number: 318-606-5335
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Mailing Address
JADETRICK I JAMES
9060 AVALON DR
SHREVEPORT, LA 71118-2532
Phone number:
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