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1194210161
KELLY MCINNIS
SHREVEPORT, LA
NPI
1194210161
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: LA OTT.Z12020)
Enumeration Date
2018-06-22
Last Update Date
2018-06-22
Business Address
KELLY MCINNIS OT
1800 BUCKNER ST STE C249
SHREVEPORT, LA 71101-4447
Phone number: 318-934-1969
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Mailing Address
KELLY MCINNIS OT
PO BOX 1377
WEST MONROE, LA 71294-1377
Phone number: 318-396-1969
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