Individual
KELLEY DOEHRTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCOTA
Contact information
Practice address
530 STRATMORE DR, SHREVEPORT, LA 71115-3020
(318) 798-3510
Mailing address
530 STRATMORE DR, SHREVEPORT, LA 71115-3020
(318) 798-3510
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
Z20635
LA
Other
Enumeration date
04/07/2015
Last updated
04/07/2015
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