Provider Demographics
NPI:1437178373
Name:MCKEE, PHILLIP ANTHONY JR (PT)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:ANTHONY
Last Name:MCKEE
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CHARLESTON DR
Mailing Address - Street 2:
Mailing Address - City:HAUGHTON
Mailing Address - State:LA
Mailing Address - Zip Code:71037-8747
Mailing Address - Country:US
Mailing Address - Phone:318-549-3542
Mailing Address - Fax:
Practice Address - Street 1:5 CHARLESTON DR
Practice Address - Street 2:
Practice Address - City:HAUGHTON
Practice Address - State:LA
Practice Address - Zip Code:71037-8747
Practice Address - Country:US
Practice Address - Phone:318-549-3542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAP.T.02713225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist