Individual
KELLY DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1500 LINE AVE, SHREVEPORT, LA 71101-4639
(318) 213-3810
Mailing address
5400 BARKSDALE BLVD, APT 412, BOSSIER CITY, LA 71112-4538
(318) 560-6192
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
08479
LA
Other
Enumeration date
03/05/2014
Last updated
03/05/2014
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