Provider Demographics
NPI:1497532824
Name:MCKEAN, KALEIGH (DPT)
Entity Type:Individual
Prefix:
First Name:KALEIGH
Middle Name:
Last Name:MCKEAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 WINDY FEATHER DR
Mailing Address - Street 2:
Mailing Address - City:BROUSSARD
Mailing Address - State:LA
Mailing Address - Zip Code:70518-7947
Mailing Address - Country:US
Mailing Address - Phone:985-351-5969
Mailing Address - Fax:
Practice Address - Street 1:5522 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592-5279
Practice Address - Country:US
Practice Address - Phone:337-703-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11320225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist