Individual
NATHAN JAMES AULTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1800 BUCKNER ST STE C249, SHREVEPORT, LA 71101-4447
(318) 934-1969
(318) 934-1960
Mailing address
PO BOX 1377, WEST MONROE, LA 71294-1377
(318) 396-1969
(318) 396-1970
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10588
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10588
LA LICENSE
LA
Enumeration date
06/02/2020
Last updated
06/02/2020
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