White Clover, LLC
NPI #1164893178 in Shreveport, Louisiana
Provider Information
- NPI Number
- 1164893178
- Entity Type
- Organization
- Organization Name
- White Clover, LLC
- Primary Specialty
- Physician Assistant
- Enumeration Date
- Oct 16, 2015
- Last Updated
- Jan 26, 2016
Practice Location
- Address
- 460 ASHLEY RIDGE BLVD
- Address 2
- STE 600
- City
- Shreveport
- State
- Louisiana
- ZIP Code
- 71106-7235
- Phone
- (318) 861-4226
Authorized Official
- Name
- MRS. TAMARA M SMITH
- Title
- CFO
- Phone
- (318) 455-8856
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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