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Individual

ERNEST CARPENTER III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LOTR

Contact information

Practice address
7607 FERN AVE STE 704, SHREVEPORT, LA 71105-5744
(318) 828-1450
Mailing address
7607 FERN AVE STE 704, SHREVEPORT, LA 71105-5744
(318) 828-1450

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.Z12249
LA

Other

Enumeration date
04/07/2018
Last updated
04/07/2018
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