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1700997160
LARRY CLYDE DANIELS
SHREVEPORT, LA
NPI
1700997160
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: LA 06282R)
Enumeration Date
2006-08-31
Last Update Date
2019-11-15
Business Address
Dr. LARRY CLYDE DANIELS MD
350 JORDAN ST
SHREVEPORT, LA 71101-4847
Phone number: 318-779-2417
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Mailing Address
Dr. LARRY CLYDE DANIELS MD
350 JORDAN STREET
SHREVEPORT, LA 71101
Phone number: 318-779-2417
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