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Individual

AMIRA GRACE EBONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
663 JORDAN ST, SHREVEPORT, LA 71101-4748
(318) 222-8892
(318) 222-8893
Mailing address
6050 TACOMA MALL BLVD STE 300, TACOMA, WA 98409-6828

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
CP039153T
LA
225100000X
Physical Therapist

Other

Enumeration date
05/26/2022
Last updated
01/27/2025
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