Individual
CARLA SHANKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
330 ALAMO ST STE 7, LAKE CHARLES, LA 70601-8584
(337) 602-6410
(281) 242-2701
Mailing address
4400 AMBASSADOR CAFFERY PKWY # 156A, LAFAYETTE, LA 70508-6760
(337) 347-5719
(281) 242-2701
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
09/08/2016
Last updated
09/08/2016
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