# WESTSIDE PHYSICAL THERAPY LLC

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

## Provider details

- **NPI number:** 1922666551
- **Authorized official:** NICOLE MARIE FABRE DPT (PHYSICAL THERAPY/OWNER)
- **Authorized official phone:** (225) 416-0333

## Contact information

- **Practice address:** 4171 HWY 1 S., STE 10, PORT ALLEN, LA 70767
- **Practice address phone:** (225) 416-0333
- **Practice address fax:** (225) 416-0332
- **Mailing address:** 4171 HWY 1 S., STE 10, PORT ALLEN, LA 70767
- **Mailing address phone:** (225) 416-0333
- **Mailing address fax:** (225) 416-0332

## Taxonomy

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

## Other

- **Enumeration date:** 05/29/2019
- **Last updated:** 06/12/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2520423 | — | LA |