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Individual

MRS. TIFFANY ENGLE AVINGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
9819 PENNINE CT, SHREVEPORT, LA 71118-4841
(318) 671-9034

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
06620
LA

Other

Enumeration date
08/23/2007
Last updated
06/09/2020
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