Organization
SPECTRA FAMILY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA MARTIN NP (OWNER)
(318) 779-1282
Entity
Organization
Contact information
Practice address
9300 MANSFIELD RD STE 209, SHREVEPORT, LA 71118-3138
(318) 779-1282
Mailing address
9300 MANSFIELD RD STE 209, SHREVEPORT, LA 71118-3138
(318) 779-1282
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/04/2019
Last updated
10/04/2019
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