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General NPI Number Information
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NPI Number | 1679874226
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Entity Type | Organization
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Legal Business Name | EASY SLEEP CONCEPTS LLC
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Dates
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Enumeration Date | 11/14/2010
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Last Update Date | 11/14/2010
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Provider Practice Location Address
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Address Line | 6030 LINE AVE STE 320
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City | SHREVEPORT
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State | LA
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Zip | 71106-2043
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Country | US
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Telephone | 318-219-4360
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Fax | 318-219-4833
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Provider Business Mailing Address
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Address Line | 6030 LINE AVE STE 320
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City | SHREVEPORT
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State | LA
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Zip | 71106-2043
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Country | US
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Telephone | 318-219-4360
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Fax | 318-219-4833
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ELLIOTT WHYTE CALVERT
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Credential |
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Telephone | 318-617-8775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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