Individual
MR. SAMUEL THOMAS FORESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
3016 JACKSON ST, ALEXANDRIA, LA 71301-4743
(318) 445-4455
(318) 445-5574
Mailing address
3016 JACKSON ST, ALEXANDRIA, LA 71301-4743
(318) 445-4455
(318) 445-5574
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
04559
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1527904
—
LA
01
—
5DW93
MEDICARE PTAN
LA
Enumeration date
05/04/2006
Last updated
06/13/2012
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