Individual
KELLY C EASTERLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
900 JOHNSON ST, TALLULAH, LA 71282-4537
(318) 574-2374
Mailing address
646 OAK ST, MANDEVILLE, LA 70448-5143
(985) 966-1223
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z12268
LA
Other
Enumeration date
07/08/2021
Last updated
07/08/2021
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