Individual
LISA DUPREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7655 GRIMM RD, SHREVEPORT, LA 71107-3450
(337) 501-6055
Mailing address
PO BOX 222, OIL CITY, LA 71061-0222
(337) 501-6055
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
00743
LA
Other
Enumeration date
10/15/2014
Last updated
10/15/2014
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