Individual
JOSEPH D FONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
5627 BANKERS AVE, BATON ROUGE, LA 70808-2615
(225) 927-3000
Mailing address
5627 BANKERS AVE, BATON ROUGE, LA 70808-2615
(225) 927-3000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
08967R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08967R
STATE LICENSE
LA
Enumeration date
09/29/2014
Last updated
12/30/2014
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