Individual
DR. NICHOLAS R FULCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
502 ANDERSON AVE, SHREVEPORT, LA 71104-3602
(318) 200-0386
(866) 825-4104
Mailing address
6123 KATELAND CIR, BOSSIER CITY, LA 71111-6988
(318) 754-7367
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10556
LA
Other
Enumeration date
06/04/2020
Last updated
08/20/2025
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