Individual
MAXINE FRAZIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3806 CLAIBORNE AVE, SHREVEPORT, LA 71109-4404
(318) 572-0176
Mailing address
3806 CLAIBORNE AVE, SHREVEPORT, LA 71109-4404
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/25/2014
Last updated
07/25/2014
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