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1811566151
MALLORY PETERS
SHREVEPORT, LA
NPI
1811566151
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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
2021-06-22
Last Update Date
2021-06-22
Business Address
MALLORY PETERS
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-626-0564
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Mailing Address
MALLORY PETERS
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-626-0564
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