DAVID MATA CANADAS

SHREVEPORT, LA
NPI1871101048
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2020-07-14
Last Update Date2020-07-14
Business Address
DAVID MATA CANADAS
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-626-0434
Mailing Address
DAVID MATA CANADAS
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-626-0434