Individual
PATRICK LAWRENCE CHILDRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.T.
Contact information
Practice address
1972 ORMOND BLVD, DESTREHAN, LA 70047-3818
(985) 307-0925
Mailing address
115 MELROSE DR, DESTREHAN, LA 70047-2117
(504) 289-0136
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
08127
LA
Other
Enumeration date
09/29/2014
Last updated
09/29/2014
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