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Organization

NORTHWEST LOUISIANA PHYSICAL MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNESS COURTNEY MD (PRESIDENT)
(318) 424-4224
Entity
Organization

Contact information

Practice address
9045 ELLERBE RD STE 107, SHREVEPORT, LA 71106-6799
(318) 424-4224
(318) 865-5330
Mailing address
1801 FAIRFIELD AVE, STE 411, SHREVEPORT, LA 71101-4443
(318) 424-4224
(318) 424-4044

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
LA

Other

Enumeration date
08/26/2005
Last updated
08/21/2024
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