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Individual

BRIAN C PRIMEAUX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5610 BUNCOMBE RD, APT. 1011, SHREVEPORT, LA 71129-2697
(337) 852-6386
Mailing address
5610 BUNCOMBE RD, APT. 1011, SHREVEPORT, LA 71129-2697
(337) 852-6386

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
46416
LA

Other

Enumeration date
02/28/2013
Last updated
05/27/2013
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