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Organization
FUNCTION FIRST PHYSICAL THERAPY, LLC
Active
Organization
FUNCTION FIRST PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY KYLE KINTZING DPT (CEO)
(318) 828-1450
Entity
Organization
Contact information
Practice address
7607 FERN AVE STE 704, SHREVEPORT, LA 71105-5744
(318) 828-1450
(318) 828-2697
Mailing address
7607 FERN AVE STE 704, SHREVEPORT, LA 71105-5744
(318) 828-1450
(318) 828-1450
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
08117
LA
2251G0304X
Geriatric Physical Therapist
Primary
08117
LA
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
11/13/2017
Last updated
07/15/2020
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