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General NPI Number Information
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NPI Number | 1184229932
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Entity Type | Individual
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Provider Name | EMILY KEATY
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Gender | Female
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Dates
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Enumeration Date | 12/01/2020
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Last Update Date | 12/01/2020
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Provider Practice Location Address
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Address Line | 624 TEXAS ST # 211
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City | SHREVEPORT
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State | LA
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Zip | 71101-3552
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Country | US
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Telephone | 318-771-7810
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Fax |
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Provider Business Mailing Address
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Address Line | 624 TEXAS ST # 211
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City | SHREVEPORT
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State | LA
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Zip | 71101-3552
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Country | US
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Telephone | 323-839-6534
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 309018
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License Number State | LA
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