Individual
QUINCY TERRELL MYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2918 MIDWAY ST, SHREVEPORT, LA 71109-5916
(318) 489-1945
Mailing address
2918 MIDWAY ST, SHREVEPORT, LA 71109-5916
(318) 489-1945
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
151669
LA
Other
Enumeration date
10/30/2023
Last updated
10/30/2023
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