Organization
WESTSIDE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE MARIE FABRE DPT (PHYSICAL THERAPY/OWNER)
(225) 416-0333
Entity
Organization
Contact information
Practice address
4171 HWY 1 S., STE 10, PORT ALLEN, LA 70767
(225) 416-0333
(225) 416-0332
Mailing address
4171 HWY 1 S., STE 10, PORT ALLEN, LA 70767
(225) 416-0333
(225) 416-0332
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2520423
—
LA
Enumeration date
05/29/2019
Last updated
06/12/2023
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