Individual
BRANT LANDRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1705 WALES LN, BOSSIER CITY, LA 71111-5143
(318) 655-1341
Mailing address
1705 WALES LN, BOSSIER CITY, LA 71111-5143
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06617
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2251P0200X
—
LA
Enumeration date
09/17/2009
Last updated
09/17/2009
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