Individual
OMEEKA SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10651 TIMBERLANE AVE, BATON ROUGE, LA 70811-1761
(225) 252-6922
Mailing address
10651 TIMBERLANE AVE, BATON ROUGE, LA 70811-1761
(225) 252-6922
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
8568345
LA
Other
Enumeration date
07/18/2016
Last updated
07/18/2016
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