# CORE PHYSICAL THERAPY AND PERFORMANCE, LLC

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

## Provider details

- **NPI number:** 1609243716
- **Authorized official:** MR. BRENNAN BERNARD (PT/CO-PWNER)
- **Authorized official phone:** (318) 868-6172

## Contact information

- **Practice address:** 460 ASHLEY RIDGE BLVD STE 800, SHREVEPORT, LA 71106-7238
- **Practice address phone:** (318) 868-6172
- **Practice address fax:** (318) 868-6173
- **Mailing address:** PO BOX 53614, LAFAYETTE, LA 70505-3614
- **Mailing address phone:** (337) 233-7977
- **Mailing address fax:** (337) 233-7978

## Taxonomy

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

## Other

- **Enumeration date:** 08/24/2015
- **Last updated:** 08/24/2015