Provider Information for 1922514553
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MEGAN RAE WOODS
Sex: Female
NPI: 1922514553
Last Updated: 2018-09-25
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1922514553 | ||||||||
| Enumeration Date | 2017-12-19 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 856 TEXAS AVE SHREVEPORT, LA 71101-3400 United States Phone: 318-429-6977 | Fax:318-227-6179 | ||||||||
| Primary Practice Address | 856 TEXAS AVE SHREVEPORT, LA 71101-3400 United States Phone: 318-429-6977 | Fax:318-227-6179 | ||||||||
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