Individual
LODIE NYCOL KYZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
536 HALF MOON LN, BOSSIER CITY, LA 71111-5576
(318) 623-2014
Mailing address
536 HALF MOON LN, BOSSIER CITY, LA 71111-5576
(318) 623-2014
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
07803
LA
Other
Enumeration date
06/18/2012
Last updated
06/18/2012
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