Individual
LISA MARIE SELLERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
726 VETERANS DR, CARENCRO, LA 70520-3619
(337) 565-4355
(337) 565-4357
Mailing address
101 MOSSWOOD CIR, LAFAYETTE, LA 70503-5238
(337) 981-9507
(337) 565-4357
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02285
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02285
LA PHYSICAL THERAPY BOARD LICENSE NUMBER
LA
Enumeration date
07/14/2015
Last updated
07/14/2015
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