Individual
BILLY GULLY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3201 KNIGHT ST APT 207, SHREVEPORT, LA 71105-2729
(318) 560-2732
Mailing address
3201 KNIGHT ST APT 207, SHREVEPORT, LA 71105-2729
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
LA
Other
Enumeration date
03/28/2017
Last updated
03/28/2017
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