Individual
KATHARINE MELDRUM KNICELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
416 BRAEMAR RD, SHREVEPORT, LA 71106-8534
(318) 393-3360
Mailing address
PO BOX 6357, SHREVEPORT, LA 71136-6357
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OTT.200401
LA
Other
Enumeration date
07/21/2010
Last updated
11/10/2023
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