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Organization

BREATHEAMERICA SHREVEPORT INC

Active
Parent organization
BREATHEAMERICA INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
BREATHEAMERICA INC
Authorized official
MR. TIMOTHY JAMES MILLER (VP MANAGED CARE)
(615) 665-7122
Entity
Organization

Contact information

Practice address
463 ASHLEY RIDGE BLVD, SUITE 100, SHREVEPORT, LA 71106-7231
(318) 221-3585
(318) 227-9094
Mailing address
463 ASHLEY RIDGE BLVD, SUITE 100, SHREVEPORT, LA 71106-7231
(318) 221-3585
(318) 227-9094

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
009735
LA

Other

Enumeration date
10/15/2012
Last updated
08/23/2013
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