Individual
LAURA KILLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
635 MCQUEEN SMITH RD N STE D, PRATTVILLE, AL 36066-5561
(334) 365-8063
Mailing address
1810 BRIARWOOD ST, PRATTVILLE, AL 36066-5587
(334) 365-9634
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2151
LICENSE #
AL
Enumeration date
08/20/2006
Last updated
07/08/2007
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