Individual
KELSEY KATE IDOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
4624 CYPRESS ST STE 8, WEST MONROE, LA 71291-1348
(318) 654-7439
Mailing address
206 HENDERSON RD, WEST MONROE, LA 71291-9409
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11173
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11173
LOUISIANA BOARD OF PHYSICAL THERAPY
LA
Enumeration date
07/26/2022
Last updated
04/30/2025
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