Clifford Allen Revoredo
Clifford Allen Revoredo is a Student in an Organized Health Care Education/Training Program in Shreveport, Louisiana. Practices as a sole proprietor. Registered with an NPI since 2024.
- In the registry since
- 2024
Practice location Address checks out
1501 Kings HwyShreveport, LA 71103-4228
Phone: (318) 626-0555
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1962259879 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | April 30, 2024 |
| Last updated in NPPES | April 30, 2024 |
| Certification date | April 30, 2024 |
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