Individual
CALEB T MCENTIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
5795 N MARKET ST STE 8, SHREVEPORT, LA 71107-2527
(318) 489-4298
(318) 489-4299
Mailing address
5795 N MARKET ST STE 8, SHREVEPORT, LA 71107-2527
(318) 489-4298
(318) 489-4299
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
09908
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09908
LA BOARD OF PHYSICAL THERAPY EXAMINERS
LA
Enumeration date
11/14/2019
Last updated
11/14/2019
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