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1982348363
GRANT GIDEON
SHREVEPORT, LA
NPI
1982348363
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-04-22
Last Update Date
2022-04-22
Business Address
GRANT GIDEON
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-626-2445
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Mailing Address
GRANT GIDEON
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number:
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