Individual
MATTIE MANUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2701 STANBERRY DR APT 8, SHREVEPORT, LA 71118-3253
(318) 280-1073
Mailing address
2701 STANBERRY DR APT 8, SHREVEPORT, LA 71118-3253
(318) 280-1073
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
LA
Other
Enumeration date
01/09/2013
Last updated
01/09/2013
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