Healthcare Provider Details

I. General information

NPI: 1861377236
Provider Name (Legal Business Name): HUNTER WILLIAM BRAUN PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4970 BARKSDALE BLVD STE 900
BOSSIER CITY LA
71112-4677
US

IV. Provider business mailing address

663 JORDAN ST
SHREVEPORT LA
71101-4748
US

V. Phone/Fax

Practice location:
  • Phone: 318-747-8892
  • Fax: 318-747-8893
Mailing address:
  • Phone: 318-222-8892
  • Fax: 318-222-8893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP054492T
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT021960
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: