Individual
SARAH CARSON BRANTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1455 E BERT KOUNS INDUSTRIAL LOOP STE 210, SHREVEPORT, LA 71105-6000
(318) 798-4623
Mailing address
1455 E BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71105-6000
(318) 798-4623
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200659
LA
363AM0700X
Medical Physician Assistant
PA.200659
LA
Other
Enumeration date
09/17/2013
Last updated
10/13/2021
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