Individual
MRS. ANGELA SUE PICKERING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5848 LINE AVE, SHREVEPORT, LA 71106-1532
(318) 865-0017
Mailing address
5848 LINE AVE, SHREVEPORT, LA 71106-1532
(318) 865-0017
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
159014
LA
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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