Individual
JEREMY LEVI CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3446 MASONIC DR, ALEXANDRIA, LA 71301-3615
(318) 443-3311
(318) 443-0023
Mailing address
1213 HIGHWAY 457, LECOMPTE, LA 71346-8718
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
08505
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08505
LOUISIANA PHYSICAL THERAPY BOARD
LA
Enumeration date
02/11/2013
Last updated
06/17/2013
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