Individual
MRS. MARIETTA SUZANNE SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6723 PINES RD STE 112, SHREVEPORT, LA 71129-2590
(318) 563-3944
Mailing address
6723 PINES RD STE 112, SHREVEPORT, LA 71129-2590
(318) 562-3944
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
04834
LA
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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