Individual
ASHLEY M MCCOLLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
9462 ELLERBE RD STE 200, SHREVEPORT, LA 71106-7446
(318) 606-5262
(318) 606-5351
Mailing address
PO BOX 80964, LAFAYETTE, LA 70598-0964
(337) 233-7977
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
07502
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07502
PHYSICAL THERAPY LICENSE
LA
Enumeration date
06/25/2020
Last updated
06/25/2020
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