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Individual

MR. SPENCER GREGORY EVANS III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1450 PETERMAN DR, ALEXANDRIA, LA 71301-3432
(318) 312-1775
Mailing address
4403 HEYMAN LN APT 140, ALEXANDRIA, LA 71303-2811
(318) 312-1775
(318) 561-9693

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
376K00000X
Nurse's Aide
Primary
325110
LA

Other

Enumeration date
06/13/2022
Last updated
11/06/2023
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