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1811645559
CHARETTA L CLARK
SHREVEPORT, LA
NPI
1811645559
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
343900000X Non-emergency Medical Transport (VAN)
(Licence: LA 007325154)
Enumeration Date
2022-03-11
Last Update Date
2022-03-11
Business Address
CHARETTA L CLARK
7125 SUNTAN ST
SHREVEPORT, LA 71108-4927
Phone number: 318-465-6614
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Mailing Address
CHARETTA L CLARK
7125 SUNTAN ST
SHREVEPORT, LA 71108-4927
Phone number: 318-205-1252
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