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Organization
THERAPEUTIC BY DESIGN FITNESS AND WELLNESS, LLC
Active
Organization
THERAPEUTIC BY DESIGN FITNESS AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER MARIE FABRE FAIRLEY P.T., PH.D., CSCS (MEMBER MANAGER)
(985) 778-2282
Entity
Organization
Contact information
Practice address
1901 HIGHWAY 190 STE 26, MANDEVILLE, LA 70448-3495
(985) 778-2282
(866) 767-8329
Mailing address
1901 HIGHWAY 190 STE 26, MANDEVILLE, LA 70448-3495
(985) 778-2282
(866) 767-8329
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
04964
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1715026
—
LA
Enumeration date
06/13/2005
Last updated
09/01/2022
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