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1801465331
SHIDESTINI MARTINEZ
SHREVEPORT, LA
NPI
1801465331
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-06-19
Last Update Date
2021-06-19
Business Address
SHIDESTINI MARTINEZ
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-626-0434
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Mailing Address
SHIDESTINI MARTINEZ
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-626-0434
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