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Organization
RILEY PHYSICAL THERAPY, INC
Active
Organization
RILEY PHYSICAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON C RILEY MPT, ATC, LAT, CKTP (PHYSICAL THERAPIST/PRESIDENT)
(318) 537-4376
Entity
Organization
Contact information
Practice address
650 OLIVE ST, SHREVEPORT, LA 71104-2210
(318) 537-4376
Mailing address
214 WINKLER WAY, MONROE, LA 71203-6527
(318) 537-4376
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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