Individual
MADISON FREMEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5948 N MARKET ST, SHREVEPORT, LA 71107-2017
(318) 375-0001
Mailing address
2020 VALLEY VIEW CIR APT 3109, BOSSIER CITY, LA 71111-4086
(985) 722-8547
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A11602
LA
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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