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1699447615
JORDAN CAGE WYATT
SHREVEPORT, LA
NPI
1699447615
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: LA 328850)
Enumeration Date
2021-09-28
Last Update Date
2022-04-14
Business Address
Mrs. JORDAN CAGE WYATT
2508 BERT KOUNS INDUSTRIAL LOOP STE 310
SHREVEPORT, LA 71118-3154
Phone number: 318-212-5880
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Mailing Address
Mrs. JORDAN CAGE WYATT
5221 AIRLINE DR
BOSSIER CITY, LA 71111-6715
Phone number: 318-840-9969
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