Provider First Line Business Practice Location Address:
1501 KINGS HWY
Provider Second Line Business Practice Location Address:
DEPARTMENT OF CARDIOLOGY
Provider Business Practice Location Address City Name:
SHREVEPORT
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71103-4228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-675-5941
Provider Business Practice Location Address Fax Number:
318-675-5686
Provider Enumeration Date:
04/18/2012