Individual
DENNIS RAY RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1310 NORTH HEARNE AVE, SHREVEPORT, LA 71107
(318) 676-5111
Mailing address
PO BOX 7904, SHREVEPORT, LA 71137-7904
(318) 676-5111
(318) 676-5021
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
105
LA
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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