Individual
KEITH CALVIN CRNKOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2122 AIRLINE DR STE 200, BOSSIER CITY, LA 71111-3270
(318) 828-1450
(318) 828-2697
Mailing address
7607 FERN AVE STE 704, SHREVEPORT, LA 71105-5744
(318) 828-1450
(318) 828-2697
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10634R
LA
Other
Enumeration date
06/22/2020
Last updated
06/23/2020
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