Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MALLORY RAE
ActiveMALLORY RAE is a Physical Therapy Assistant healthcare provider located in SHREVEPORT, Louisiana. NPI 1063385698 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · SHREVEPORT, LA
Registration Details
- NPI Number
- 1063385698
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 29, 2025 (0.89914893770269 yrs)
- Last Updated
- Sep 29, 2025
- License
-
12179 (LA)
Practice Information
- Address
-
1501 KINGS HWYSHREVEPORT, LA, 711034228Browse LA providers · Browse ZIP 71103
- Phone
- 3186260000
- Primary Specialty
-
Physical Therapy Assistant
225100000X
Other Physical Therapy Assistant Providers in SHREVEPORT, LA
| Name | Credential | NPI |
|---|---|---|
| MARTIN S YOUNG | L.P.T. | 1407854367 |
| MR. LARRY NELS LARSEN | P.T., A.T.C., S.T.S. | 1497740088 |
| TERRY L EBERHARDT | PT | 1558358101 |
| LINDSAY TURNER CARADONNA | PT | 1265408868 |
| MR. JASON RILEY | MPT, ATC, LAT, CKTP | 1861444200 |
| DR. GREGORY JAMES REDMOND | DPT | 1407894355 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.