THERON EVANS

SHREVEPORT, LA
NPI1902278641
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: LA  200290)
Enumeration Date2015-10-21
Last Update Date2015-10-21
Business Address
-- THERON EVANS
403 E FLOURNOY LUCAS RD
SHREVEPORT, LA 71115-3906
Phone number: 318-213-3500
Mailing Address
-- THERON EVANS
PO BOX 579
SUMMIT, MS 39666-0579
Phone number: 601-276-3900
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