Individual
JUSTIN ELLIS ALFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
663 JORDAN ST, SHREVEPORT, LA 71101-4748
(318) 222-8892
Mailing address
663 JORDAN ST, SHREVEPORT, LA 71101-4748
(318) 222-8892
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
09614
LA
Other
Enumeration date
07/09/2020
Last updated
07/09/2020
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