Doctor Name: | LOIS RAYNER MABERRY |
NPI Number: | 1801939970 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 1103R |
Business Practice Address: | 1500 Line Ave Shreveport, LA - 711014639 |
Business Phone Number: | 3182133800 |
Business Fax Number: | |
Mailing Address: | 137 Promenade Ave, SHREVEPORT |
State: | LA |
Postal Code: | 711153241 |
Phone Number: | 3182865414 |
Fax Number: | |
NPI Enumeration Date: | 02/15/2007 |
NPI Last Update Date: | 09/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1103R |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |