# EBERHARDT PHYSICAL THERAPY & WELLNESS CLINIC, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023202694
- **Authorized official:** GREGORY JAMES REDMOND DPT (CEO)
- **Authorized official phone:** (318) 222-7442

## Contact information

- **Practice address:** 820 JORDAN ST STE 150, SHREVEPORT, LA 71101-4529
- **Practice address phone:** (318) 222-7442
- **Practice address fax:** (318) 424-4751
- **Mailing address:** 820 JORDAN ST STE 150, SHREVEPORT, LA 71101-4529
- **Mailing address phone:** (318) 222-7442
- **Mailing address fax:** (318) 424-4751

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225700000X | Massage Therapist | — | NULL | — |
| 225700000X | Massage Therapist | — | — | — |

## Other

- **Enumeration date:** 08/28/2007
- **Last updated:** 08/27/2025