Individual
MR. KELLY T HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
103 NORTHPARK BLVD, SUITE 205, COVINGTON, LA 70433-6119
(985) 871-7878
(985) 871-9355
Mailing address
1305 ANDORRA LN, COVINGTON, LA 70433-4546
(985) 871-5124
(985) 871-9355
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A6846R
LA
Other
Enumeration date
08/10/2006
Last updated
07/08/2007
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