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1730280264
ELLIS REED MAXWELL
SHREVEPORT, LA
NPI
1730280264
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: LA 079757)
Enumeration Date
2006-09-26
Last Update Date
2007-07-08
Business Address
MR. ELLIS REED MAXWELL CRNA
501 EAST STONER AVE
SHREVEPORT, LA 71101
Phone number: 318-221-8411
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Mailing Address
MR. ELLIS REED MAXWELL CRNA
9409 RED OAK LANE
SHREVEPORT, LA 71106
Phone number: 318-219-8580
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