Individual
KAVON HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2036 DYLAN DR, SLIDELL, LA 70461-4838
(214) 205-6740
Mailing address
2036 DYLAN DR, SLIDELL, LA 70461-4838
(214) 205-6740
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
010730725
LA
Other
Enumeration date
10/03/2023
Last updated
10/03/2023
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