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Individual

CELESTE ANTOINETTE SHIELD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1100 LAKE FRANCES DR, GRETNA, LA 70056-8317
(904) 309-3267
Mailing address
1100 LAKE FRANCES DR, GRETNA, LA 70056-8317
(904) 309-3267

Taxonomy

Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
42641603K
LA

Other

Enumeration date
06/29/2018
Last updated
06/29/2018
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