Organization
NATURAL GROUND THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI GAUTREAX-KLIEBERT LMT (OWNER)
(985) 335-6442
Entity
Organization
Contact information
Practice address
38581 MADDY LN, PONCHATOULA, LA 70454-5084
(985) 335-6442
Mailing address
38581 MADDY LN, PONCHATOULA, LA 70454-5084
(985) 335-6442
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
133VN1501X
Sports Dietetics Nutrition Registered Dietitian
—
—
171400000X
Health & Wellness Coach
—
—
172M00000X
Mechanotherapist
Primary
—
—
174H00000X
Health Educator
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
05/14/2024
Last updated
05/15/2024
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