IndividualActive
Keona Isaac
NPI 1609647726 · Prosthetic/Orthotic Supplier · Tallulah, LA
Provider details
- NPI number
- 1609647726
- Entity type
- Individual
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 1334671108 (LA)
Specialties & taxonomies
Suppliers
Practice location
120 Kimbrough Blvd
Tallulah, LA 71282-4307
Phone: (318) 341-6785
Approximate (ZIP-level) locationGet directions
Mailing address
120 Kimbrough Blvd
Tallulah, LA 71282-4307
Registry dates
- Enumerated
- 2024-01-09
- Last updated
- 2024-01-09
- Certified
- 2024-01-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.