Healthcare Provider Details

I. General information

NPI: 1659518041
Provider Name (Legal Business Name): CORNERSTONE THERAPY AND BALANCE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2009
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8961 YOUREE DR
SHREVEPORT LA
71115-3001
US

IV. Provider business mailing address

8961 YOUREE DR
SHREVEPORT LA
71115-3001
US

V. Phone/Fax

Practice location:
  • Phone: 318-671-8772
  • Fax: 318-671-8776
Mailing address:
  • Phone: 318-671-8772
  • Fax: 318-671-8776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. COAN ALAN KNIGHT
Title or Position: CO-OWNER
Credential: PT
Phone: 318-671-8772