# ALL SOUTH PROFESSIONAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558580696
- **Authorized official:** MRS. CRYSTAL ADAMS BONURA MPT (PHYSICAL THERAPIST)
- **Authorized official phone:** (504) 909-8773

## Contact information

- **Practice address:** 5624 ERLANGER RD, KENNER, LA 70065-1564
- **Practice address phone:** (504) 301-1310
- **Practice address fax:** (504) 466-6367
- **Mailing address:** 5624 ERLANGER RD, KENNER, LA 70065-1564
- **Mailing address phone:** (504) 301-1310
- **Mailing address fax:** (504) 466-6367

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 04130 | LA | Yes |

## Other

- **Enumeration date:** 04/25/2007
- **Last updated:** 06/16/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1068128 | — | LA |