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1710561915
JAKE CONLY
BOSSIER CITY, LA
NPI
1710561915
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: LA 10888)
Enumeration Date
2021-05-12
Last Update Date
2021-05-12
Business Address
Dr. JAKE CONLY PT, DPT
5510 AIRLINE DR STE 104
BOSSIER CITY, LA 71111-6728
Phone number: 318-935-9075
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Mailing Address
Dr. JAKE CONLY PT, DPT
PO BOX 255
STONEWALL, LA 71078-0255
Phone number: 318-470-3111
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