Individual
KEOSHA LASHELL HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
424 MCARTHUR RD, FAYETTEVILLE, NC 28311-6924
(910) 868-2002
(910) 868-2004
Mailing address
2757 MEWBORN CHURCH RD, SNOW HILL, NC 28580-8973
(615) 426-6174
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A4470
NC
Other
Enumeration date
05/26/2018
Last updated
05/26/2018
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