Individual
HOLLY GAINES SCURLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9300 MANSFIELD RD, SHREVEPORT, LA 71118-3155
(318) 629-3763
(318) 629-3767
Mailing address
9300 MANSFIELD RD, SHREVEPORT, LA 71118-3155
(318) 629-3763
(318) 629-3767
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.200600
LA
Other
Enumeration date
02/23/2013
Last updated
02/23/2013
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