Organization
BEAUREGARD PHYSICAL THERAPY CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMEY JEROME JOHNSON MPT (OWNER/PRESIDENT/PHYSICAL THERAPIST)
(337) 462-6097
Entity
Organization
Contact information
Practice address
309 S WASHINGTON ST, DERIDDER, LA 70634-4861
(337) 462-6097
(337) 462-0531
Mailing address
309 S WASHINGTON ST, DERIDDER, LA 70634-4861
(337) 462-6097
(337) 462-0531
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT06472
LA PHYSICAL THERAPY BOARD
LA
Enumeration date
04/17/2008
Last updated
07/18/2022
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