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1902386915
LYDIA PROTHRO
SHREVEPORT, LA
NPI
1902386915
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: LA A10065R)
Enumeration Date
2018-08-19
Last Update Date
2018-08-19
Business Address
Mrs. LYDIA PROTHRO PTA
6969 FERN AVE LOOP
SHREVEPORT, LA 71105-4159
Phone number: 318-383-0022
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Mailing Address
Mrs. LYDIA PROTHRO PTA
324 CAMDEN HL
HAUGHTON, LA 71037-8779
Phone number: 318-347-0797
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