Most Relevant Information
Provider Data
| NPI Number: | 1003541640 |
| Provider Name: | KELLY QUEBEDEAUX DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 09172 |
Most Important Dates
| Enumeration Date: | 07/18/2022 |
| Last Updated: | 07/18/2022 |
Provider Practice Location
1050 S FOSTER DR
BATON ROUGE
LA
708067221
Practice Location Phone/Fax
| Phone: | 5049127807 |
| Fax: |
Provider Mailing Location
15230 GERMANY OAKS BLVD
PRAIRIEVILLE
LA
707695055
Provider Mailing Phone/Fax
| Phone: | 5049127807 |
| Fax: |