Individual
ANDREW ELLIS JUDLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1519 CRESWELL AVE, SHREVEPORT, LA 71101-4774
(318) 869-1899
Mailing address
3741 GREENWAY PL, SHREVEPORT, LA 71105-2013
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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