Individual
JACQUELINE RAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4108 FOREST OAK DR, SHREVEPORT, LA 71109-8320
(318) 453-2855
Mailing address
4108 FOREST OAK DR, SHREVEPORT, LA 71109-8320
(318) 453-2855
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
008564170
LA
Other
Enumeration date
02/01/2023
Last updated
02/01/2023
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