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Organization
FULTZ PHYSICAL THERAPY AND JOINT REHAB, LLC
Active
Organization
FULTZ PHYSICAL THERAPY AND JOINT REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER FULTZ P.T. (P.T./OWNER)
(318) 606-5262
Entity
Organization
Contact information
Practice address
9462 ELLERBE RD STE 200, SHREVEPORT, LA 71106-7466
(318) 606-5262
(318) 402-0802
Mailing address
9462 ELLERBE RD STE 200, SHREVEPORT, LA 71106-7466
(318) 606-5262
(318) 402-0802
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952790917
NPI
—
Enumeration date
10/16/2018
Last updated
07/12/2023
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