Organization
ALL SOUTH PROFESSIONAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CRYSTAL ADAMS BONURA MPT (PHYSICAL THERAPIST)
(504) 909-8773
Entity
Organization
Contact information
Practice address
5624 ERLANGER RD, KENNER, LA 70065-1564
(504) 301-1310
(504) 466-6367
Mailing address
5624 ERLANGER RD, KENNER, LA 70065-1564
(504) 301-1310
(504) 466-6367
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
04130
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1068128
—
LA
Enumeration date
04/25/2007
Last updated
06/16/2008
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