Individual
CONNOR ROAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
39 CHIMNEY STONE WAY, SHREVEPORT, LA 71115-3154
(318) 401-7756
Taxonomy
Speciality
Code
Description
License number
State
246RM2200X
Medical Laboratory Technician
Primary
327785
LA
Other
Enumeration date
06/29/2022
Last updated
06/29/2022
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