Organization
GENETICS COLLECTION LLC
Active
Organization
GENETICS COLLECTION LLC
Active
Other names
Genetics Collection
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANTISKA TUJUNNA HAYNES LPN (OWNER)
(318) 505-2079
Entity
Organization
Contact information
Practice address
214 W 70TH ST STE 205, SHREVEPORT, LA 71106-3756
(318) 505-2079
Mailing address
214 W 70TH ST STE 205, SHREVEPORT, LA 71106-3756
(318) 505-2079
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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