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Individual

MARISSA ADAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1811 E BERT KOUN LOOP, SUITE 110, SHREVEPORT, LA 71105-5740
(318) 212-3858
(318) 212-3958
Mailing address
1811 E BERT KOUN LOOP, SUITE 110, SHREVEPORT, LA 71105-5740
(318) 212-3858
(318) 212-3958

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
200750
LA

Other

Enumeration date
12/04/2014
Last updated
08/20/2024
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