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Individual

CARSON KOLBENSCHLAG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1450 CLAIBORNE AVE, SHREVEPORT, LA 71103-4204
(318) 813-2970
(318) 813-2981
Mailing address
PO BOX 33932, SHREVEPORT, LA 71130-3932
(318) 813-2970
(318) 813-2975

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A10462R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1174173
LA
Enumeration date
09/03/2020
Last updated
09/03/2020
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