| NPI | 1164797973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY RAE SANTINE LANDRY Owner/Physical Therapist 228-354-0093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2012-03-12 |
| Last Update Date | 2012-03-14 |