Organization
TRI-STATE PHYSICAL THERAPY NUMBER 1 INC
Active
Other names
TRI-STATE PHYSICAL
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAN B TURNER PT (PRESIDENT/ADMINISTRATOR)
(318) 631-7999
Entity
Organization
Contact information
Practice address
8660 FERN AVE STE 160, SHREVEPORT, LA 71105-5694
(318) 631-7999
(318) 631-9528
Mailing address
P O BOX 52038, SHREVEPORT, LA 71135-2038
(318) 631-7999
(318) 631-9528
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5C749
MEDICARE
LA
Enumeration date
05/12/2006
Last updated
09/11/2017
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