Brentwood Acquisition Shreveport, Inc

NPI 1063644383 - Clinic/Center - 261QM2500X

NPI Details
NPI 1063644383
Enumeration Date 08/20/2009
Last Updated 08/20/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name JODI LYNN JODI
Position OFFICE MANAGER
Phone (318) 222-6226
Fax (318) 222-6227
Practice Location
1002 HIGHLAND AVE
SUITE 200
SHREVEPORT LA, 71101-4143, US
Phone (318) 222-6226
Fax (318) 222-6227
Business Location
1002 HIGHLAND AVE
SUITE 200
SHREVEPORT LA, 71101-4143, US
Phone (318) 222-6226
Fax (318) 222-6227
Toxanomy
Taxonomy Code 261QM2500X
License State
License Number
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According to our database, Brentwood Acquisition Shreveport, Inc NPI is 1063644383, taxonomy code is 261QM2500X Brentwood Acquisition Shreveport, Inc physically located at 1002 Highland Ave, Shreveport LA, 71101-4143. NPI Number 1033115704 has the healthcare provider type.

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1063644383 NPI number is provided on an as is basis without warranty of any kind. 1063644383 is maintained by the National Plan & Provider Enumeration System. The contents of Brentwood Acquisition Shreveport, Inc are for informational purposes only.