Santine Landry, Kelly Rae

Santine Landry, Kelly Rae is an sole proprietor health care provider with primary practice located at 4063 Ginger Dr Suite C, Diberville MS 39540-3705. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Santine Landry, Kelly Rae can be contacted via phone (228) 354-0093.

Contact Information

Primary practice address
4063 Ginger Dr Suite C Diberville MS 39540-3705
Phone: (228) 354-0093
Fax: (228) 354-0094
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT2207 Mississippi

Profile Details

NPI number 1396868568
LBN Legal business name Santine Landry, Kelly Rae
Credentials Master of Physical Therapy (MPT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 10th, 2007
Last updated Mar 12th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396868568 NPPES
Mississippi MEDICAID 0121391

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