JORDAN CAGE WYATT

SHREVEPORT, LA
NPI1699447615
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: LA  328850)
Enumeration Date2021-09-28
Last Update Date2022-04-14
Business Address
Mrs. JORDAN CAGE WYATT
2508 BERT KOUNS INDUSTRIAL LOOP STE 310
SHREVEPORT, LA 71118-3154
Phone number: 318-212-5880
Mailing Address
Mrs. JORDAN CAGE WYATT
5221 AIRLINE DR
BOSSIER CITY, LA 71111-6715
Phone number: 318-840-9969
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