Individual
MR. JOEL SHANNON UTLEY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
705 DREW LN, MINDEN, LA 71055-2901
(918) 207-2730
Mailing address
705 DREW LN, MINDEN, LA 71055-2901
(918) 207-2730
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/18/2021
Last updated
02/18/2021
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