Individual
JASON STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2495 SHREVEPORT HWY # 71, PINEVILLE, LA 71360-4044
(318) 473-0010
Mailing address
PO BOX 69004, ALEXANDRIA, LA 71306-9004
(318) 473-0010
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A8235
LA
Other
Enumeration date
07/07/2015
Last updated
07/07/2015
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