Organization
WK SPINE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J GAVIN (NETWORK ADMINISTRATOR)
(318) 212-8951
Entity
Organization
Contact information
Practice address
8001 YOUREE DR STE 450, SHREVEPORT, LA 71115-2333
(318) 212-3706
(318) 212-3846
Mailing address
8001 YOUREE DR STE 450, SHREVEPORT, LA 71115-2333
(318) 212-3706
(318) 212-3846
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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