Diabetes Assessment And Management Center Of Shreveport LLC
Dietitian, Registered in Shreveport, LA. Organization (NPI-2).
NPI number1972058170
StatusActive
Last updated in NPPESAug 18, 2016
Details
- NPI
- 1972058170
- Entity type
- Organization (NPI-2)
- Legal business name
- Diabetes Assessment And Management Center Of Shreveport LLC
- Organization subpart
- No
- Enumeration date
- Aug 18, 2016
- Last updated
- Aug 18, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | – | LA | Yes |
Practice location
1560 Irving PlShreveport, LA 71101-4604
Phone 318-212-1194 · Fax 318-212-1196
Mailing address
1560 Irving PlShreveport, LA 71101-4604
Phone 318-212-1194 · Fax 318-212-1196
Authorized official
Charles C. Crenshaw
President
3182121194
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