Individual
BERANNA R SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8186 DANCE DR., SHREVEPORT, LA 71129
(318) 347-3585
Mailing address
8186 DANCE DR, SHREVEPORT, LA 71129-9707
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A09482R
LA
Other
Enumeration date
09/11/2017
Last updated
09/11/2017
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