Provider Demographics
NPI:1063226561
Name:CREEL, ADDISON (DPT)
Entity type:Individual
Prefix:
First Name:ADDISON
Middle Name:
Last Name:CREEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:446 KNAPP RD
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71343-1576
Mailing Address - Country:US
Mailing Address - Phone:318-339-6401
Mailing Address - Fax:601-445-9032
Practice Address - Street 1:2801 FOURTH ST STE 4
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71343-2027
Practice Address - Country:US
Practice Address - Phone:318-339-6401
Practice Address - Fax:601-445-9032
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA11962225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist