Individual
KATELYN A HEADRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
3100 SAMFORD AVE, SHREVEPORT, LA 71103-4239
(318) 222-5704
Mailing address
3100 SAMFORD AVE, SHREVEPORT, LA 71103-4239
(318) 222-5704
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
09527R
LA
225100000X
Physical Therapist
1282375
TX
Other
Enumeration date
12/09/2021
Last updated
12/09/2021
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