Individual
MRS. CARLA FISHER KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
104 OAK ALY, MANDEVILLE, LA 70471-3062
(251) 510-4016
Mailing address
104 OAK ALY, MANDEVILLE, LA 70471-3062
(251) 510-4016
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
03723
LA
2251P0200X
Pediatric Physical Therapist
PTH4543
AL
Other
Enumeration date
06/15/2008
Last updated
01/24/2012
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