Organization
BRENTWOOD ACQUISITION SHREVEPORT, INC
Active
Other names
Brentwood Outpatient Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JODI LYNN BURNS (OFFICE MANAGER)
(318) 222-6260
Entity
Organization
Contact information
Practice address
1002 HIGHLAND AVE, SUITE 200, SHREVEPORT, LA 71101-4143
(318) 222-6226
(318) 222-6227
Mailing address
1002 HIGHLAND AVE, SUITE 200, SHREVEPORT, LA 71101-4143
(318) 222-6226
(318) 222-6227
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/20/2009
Last updated
08/20/2009
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