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Individual

BETH M CHILDERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
231 DEVON RD, LA PLACE, LA 70068-5205
(985) 212-1660
Mailing address
231 DEVON RD, LA PLACE, LA 70068-5205
(985) 212-1660

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
00336
LA
225100000X
Physical Therapist
1027837
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1503436
LA
Enumeration date
12/13/2006
Last updated
07/09/2007
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