Individual
BRANDI STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1756 GOLDEN RD, SULPHUR, LA 70665-8199
(337) 405-9379
Mailing address
1756 GOLDEN RD, SULPHUR, LA 70665-8199
(337) 405-9379
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
08203
LA
Other
Enumeration date
09/22/2011
Last updated
02/05/2020
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