Provider First Line Business Practice Location Address:
3730 BLAIR DR
Provider Second Line Business Practice Location Address:
LSUHSC-SCHOOL OF ALLIED HEALTH PROFESSIONALS
Provider Business Practice Location Address City Name:
SHREVEPORT
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71103-4602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-632-2030
Provider Business Practice Location Address Fax Number:
318-675-7737
Provider Enumeration Date:
07/27/2006