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General NPI Number Information
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NPI Number | 1871148346
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Entity Type | Individual
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Provider Name | KERI ANNE BAIR PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/01/2019
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Last Update Date | 08/01/2019
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Provider Practice Location Address
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Address Line | 403 E FLOURNOY LUCAS RD
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City | SHREVEPORT
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State | LA
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Zip | 71115-3906
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Country | US
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Telephone | 318-758-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 1105 ISLAND PARK BLVD APT 807
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City | SHREVEPORT
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State | LA
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Zip | 71105-4770
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 10376
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License Number State | LA
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