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General NPI Number Information
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NPI Number | 1144782905
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Entity Type | Organization
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Legal Business Name | FYZICAL OF ALEXANDRIA LLC
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 04/17/2020
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Provider Practice Location Address
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Address Line | 221 WINDERMERE BLVD STE A
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3538
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Country | US
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Telephone | 318-545-7878
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Fax |
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Provider Business Mailing Address
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Address Line | 221 WINDERMERE BLVD
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3538
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DANIELLE TRANTHAM
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Credential |
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Telephone | 318-427-3308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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