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Organization

FULTZ PHYSICAL THERAPY AND JOINT REHAB, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTOPHER FULTZ P.T. (P.T./OWNER)
(318) 606-5262
Entity
Organization

Contact information

Practice address
9462 ELLERBE RD STE 200, SHREVEPORT, LA 71106-7466
(318) 606-5262
(318) 402-0802
Mailing address
9462 ELLERBE RD STE 200, SHREVEPORT, LA 71106-7466
(318) 606-5262
(318) 402-0802

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1952790917
NPI
Enumeration date
10/16/2018
Last updated
07/12/2023
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