Organization
FUNCTION FIRST PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY KYLE KINTZING DPT (CEO)
(318) 828-1450
Entity
Organization
Contact information
Practice address
7607 FERN AVE STE 704, SHREVEPORT, LA 71105-5744
(318) 828-1450
(318) 828-2697
Mailing address
7607 FERN AVE STE 704, SHREVEPORT, LA 71105-5744
(318) 828-1450
(318) 828-1450
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
08117
LA
2251G0304X
Geriatric Physical Therapist
Primary
08117
LA
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
11/13/2017
Last updated
07/15/2020
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