Individual
CARL A KELLY IV
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2611 GREENWOOD RD, SHREVEPORT, LA 71103-3907
(318) 631-2020
(318) 621-3023
Mailing address
2611 GREENWOOD RD, SHREVEPORT, LA 71103-3907
(318) 631-2020
(318) 621-3023
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1343-477T
LA
Other
Enumeration date
10/25/2005
Last updated
07/08/2007
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