# WHITE CLOVER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** White Clover Wellness & Research Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164893178
- **Authorized official:** MRS. TAMARA M SMITH (CFO)
- **Authorized official phone:** (318) 455-8856

## Contact information

- **Practice address:** 460 ASHLEY RIDGE BLVD, STE 600, SHREVEPORT, LA 71106-7235
- **Practice address phone:** (318) 861-4226
- **Mailing address:** 460 ASHLEY RIDGE BLVD, STE 600, SHREVEPORT, LA 71106-7235
- **Mailing address phone:** (318) 861-4226

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 10/16/2015
- **Last updated:** 01/26/2016