Individual
THERESA JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1959 HWY 3125, SUITE 3, LUTCHER, LA 70071
(225) 258-9301
(225) 258-9300
Mailing address
2816 N. NOBILE STREET, PAULINA, LA 70763
(225) 806-3940
(225) 258-9300
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06530
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12661185
CAQH
—
05
—
2590359
—
LA
Enumeration date
02/06/2014
Last updated
05/12/2023
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