Individual
ARCHNA SHASTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7591 FERN AVE STE 1203, SHREVEPORT, LA 71105-5763
(318) 828-2972
Mailing address
407 OAKWOOD TRACE CT, SHREVEPORT, LA 71106-8314
(614) 284-2956
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
08363R
LA
2251X0800X
Orthopedic Physical Therapist
08363R
LA
Other
Enumeration date
03/16/2007
Last updated
09/12/2023
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