Individual
DR. ALISA KAY BROGDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
5848 LINE AVE, SHREVEPORT, LA 71106-1532
(318) 865-0017
(318) 868-4738
Mailing address
5848 LINE AVE, SHREVEPORT, LA 71106-1532
(318) 865-0017
(318) 868-4738
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1533-563T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1715204
—
LA
Enumeration date
08/17/2006
Last updated
04/11/2016
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