Individual
KAYLA COX BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
11451 MOSS SIDE DR, GONZALES, LA 70737-7777
(225) 317-2744
Mailing address
11451 MOSS SIDE DR, GONZALES, LA 70737-7777
(225) 317-2744
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
02302
LA
Other
Enumeration date
02/16/2011
Last updated
02/16/2011
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