Individual
PEYTON RACHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0008
(318) 675-7934
Mailing address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0008
(318) 675-7934
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
324558
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/06/2020
Last updated
07/15/2021
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