Individual
TERRY L EBERHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
8731 PARK PLAZA DR, SHREVEPORT, LA 71105-5682
(318) 797-5848
(318) 797-5844
Mailing address
8731 PARK PLAZA DR, SHREVEPORT, LA 71105-5682
(318) 797-5848
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 00295
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11405983
CAQH
—
05
—
2579568
—
LA
Enumeration date
09/29/2005
Last updated
10/04/2024
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