Organization
SNELLS LIMBS & BRACES OF SHREVEPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLYDE N MASSEY CPO (VICE PRESIDENT)
(318) 424-4167
Entity
Organization
Contact information
Practice address
8730 YOUREE DR, BUILDING A, SHREVEPORT, LA 71115-2518
(318) 795-0953
Mailing address
1833 LINE AVE, SHREVEPORT, LA 71101-4611
(318) 424-4167
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/04/2008
Last updated
11/15/2012
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