Individual
MR. CHANCE QUEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
8001 YOUREE DR, SHREVEPORT, LA 71115-2302
(318) 212-3000
Mailing address
359 AVONDALE LN, BOSSIER CITY, LA 71112-4247
(318) 541-6882
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/28/2025
Last updated
04/28/2025
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