Individual
SHELBY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1316 E KENTUCKY AVE, RUSTON, LA 71270-6609
(318) 224-9081
(318) 224-9083
Mailing address
1316 E KENTUCKY AVE, RUSTON, LA 71270-6609
(318) 224-9081
(318) 224-9083
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/23/2022
Last updated
05/23/2022
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