Individual
JOSEPH AARON ROSSUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHS
Contact information
Practice address
9403 MANSFIELD RD, SHREVEPORT, LA 71118
(318) 603-4396
Mailing address
7442 WATERWOOD DR, GREENWOOD, LA 71033-3366
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760852511
LOUISIANA HEALTH CONECTION
LA
05
—
1760852511
—
LA
Enumeration date
01/26/2018
Last updated
05/21/2018
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