Organization
SHREVEPORT AQUATIC AND LAND PHYSICAL THERAPY. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AARON BLICK (CEO)
(214) 295-6703
Entity
Organization
Contact information
Practice address
6969 FERN LOOP, SHREVEPORT, LA 71105-4159
(214) 295-6703
Mailing address
6969 FERN LOOP, SHREVEPORT, LA 71105-4159
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
03/21/2018
Last updated
05/11/2018
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