Individual
MS. LAKEITRA HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2469 STELZER RD, COLUMBUS, OH 43219-3129
(614) 416-6200
Mailing address
714 6TH ST SW APT B, BIRMINGHAM, AL 35211-1657
(205) 603-1003
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2133652
TX
225200000X
Physical Therapy Assistant
Primary
PTA004101
GA
225200000X
Physical Therapy Assistant
PTA8739
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/07/2016
Last updated
02/22/2019
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