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Organization
SHREVEPORT PHYSICAL THERAPY AND SPORTS MEDICINE, INC.
Active
Organization
SHREVEPORT PHYSICAL THERAPY AND SPORTS MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT A KENNEY III PT (PT)
(318) 617-2668
Entity
Organization
Contact information
Practice address
8835 LINE AVE STE 100, SHREVEPORT, LA 71106-6731
(318) 681-5437
(318) 681-5685
Mailing address
PO BOX 5477, SHREVEPORT PHYSICAL THERAPY & SPORTS MEDICINE, SHREVEPORT, LA 71135-5477
(318) 681-5633
(318) 681-5685
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
02/23/2007
Last updated
07/29/2019
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