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Organization
WK PIERRE AVE COMMUNITY HEALTH EDUCATION AND WELLNESS CENTER
Active
Organization
WK PIERRE AVE COMMUNITY HEALTH EDUCATION AND WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J GAVIN (NETWORK ADMINISTRATOR)
(318) 212-8624
Entity
Organization
Contact information
Practice address
1327 PIERRE AVE, SHREVEPORT, LA 71103-3056
(318) 212-8624
(318) 226-8545
Mailing address
1327 PIERRE AVE, SHREVEPORT, LA 71103-3056
(318) 212-8624
(318) 226-8545
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/06/2006
Last updated
05/14/2014
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