NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1770126344
EVANS
BERTRESEA
WHITE
1651 E 70TH ST # 151
SHREVEPORT
LA
711055115
1477275014
MCINNIS
DRUE
2648 OAKSIDE DR
HAUGHTON
LA
710379308
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