Organization
DIABETES ASSESSMENT AND MANAGEMENT CENTER OF SHREVEPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES C. CRENSHAW (PRESIDENT)
(318) 212-1194
Entity
Organization
Contact information
Practice address
1560 IRVING PL, SHREVEPORT, LA 71101-4604
(318) 212-1194
(318) 212-1196
Mailing address
1560 IRVING PL, SHREVEPORT, LA 71101-4604
(318) 212-1194
(318) 212-1196
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
LA
Other
Enumeration date
08/18/2016
Last updated
08/18/2016
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