Individual
CONNIE FROST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4633 WICHERS DR, MARRERO, LA 70072-3002
(504) 347-0733
(504) 378-9329
Mailing address
PO BOX 848766, BOSTON, LA 02284-8766
(504) 347-5421
(504) 340-5171
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02740
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02740
PT LICENSE
LA
01
—
1053570333
BLUE CROSS/BLUE SHIELD
—
Enumeration date
06/03/2008
Last updated
01/30/2015
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