Magnolia Diagonstic Services Inc.
NPI #1821225806 in Shreveport, Louisiana
Provider Information
- NPI Number
- 1821225806
- Entity Type
- Organization
- Organization Name
- Magnolia Diagonstic Services Inc.
- Primary Specialty
- Clinic/Center - Multi-Specialty
- Enumeration Date
- Jun 17, 2009
- Last Updated
- Jun 17, 2009
Practice Location
- Address
- 2005 CRESWELL AVE
- City
- Shreveport
- State
- Louisiana
- ZIP Code
- 71104-2201
- Phone
- (318) 678-0709
Authorized Official
- Name
- MR. DEWARRENT L. BRANTLEY
- Title
- CEO/ PRESIDENT
- Phone
- (318) 678-0709
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Multi-Specialty — Multi-Specialty |
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