Individual
MRS. HOLLIS WALSDORF FOUSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1714 WOLF CIR, LAKE CHARLES, LA 70605-2353
(337) 304-8024
Mailing address
1906 CALVIN CT, LAKE CHARLES, LA 70607-7715
(985) 778-9306
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A7726
LA
225200000X
Physical Therapy Assistant
PTA-010009
AZ
Other
Enumeration date
02/14/2020
Last updated
02/14/2020
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