NPI 1114077476

Kellie D Corman, LMT

Practitioner Massage Therapist Lake Charles, LA

Practice location

Address: 5843 Elliott Rd, Lake Charles, LA 70605-0401
Phone: (337) 478-0834

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence LA0232-01 (LA)

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Registry record

NPI: 1114077476
Entity type: Individual
Sex (as registered): Female
NPI issued: 11 Jan 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.