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Individual

KYRON PEACOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6700 HIGHWAY 165 N, MONROE, LA 71203-8753
(318) 325-4709
Mailing address
4109 HIGHWAY 98 W, SUMMIT, MS 39666-9132

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
00260R
LA

Other

Enumeration date
06/15/2009
Last updated
06/15/2009
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