Organization
BMMG, LLC
Active
Other names
CryoSpa
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW FRANZ ST. AMANT (MEMBER)
(318) 742-3408
Entity
Organization
Contact information
Practice address
6030 LINE AVE, SHREVEPORT, LA 71106-2062
(318) 742-3408
Mailing address
816 BENTON RD, BOSSIER CITY, LA 71111-3744
(318) 747-8895
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
08831R
TX
Other
Enumeration date
11/20/2015
Last updated
11/20/2015
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