Organization
THERAPEUTIC BY DESIGN FITNESS AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER MARIE FABRE FAIRLEY P.T., PH.D., CSCS (MEMBER MANAGER)
(985) 778-2282
Entity
Organization
Contact information
Practice address
1901 HIGHWAY 190 STE 26, MANDEVILLE, LA 70448-3495
(985) 778-2282
(866) 767-8329
Mailing address
1901 HIGHWAY 190 STE 26, MANDEVILLE, LA 70448-3495
(985) 778-2282
(866) 767-8329
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
04964
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1715026
—
LA
Enumeration date
06/13/2005
Last updated
09/01/2022
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