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General NPI Number Information
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NPI Number | 1326419177
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Entity Type | Organization
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Legal Business Name | DESOTO PHYSICAL THERAPY, L.L.C.
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Dates
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Enumeration Date | 10/19/2015
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Last Update Date | 08/18/2022
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Provider Practice Location Address
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Address Line | 318 PLANTATION HILLS BLVD
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City | STONEWALL
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State | LA
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Zip | 71078-9415
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Country | US
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Telephone | 318-775-9870
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Fax | 318-775-9884
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Provider Business Mailing Address
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Address Line | 318 PLANTATION HILLS BLVD
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City | STONEWALL
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State | LA
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Zip | 71078
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Country | US
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Telephone | 318-775-9870
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Fax | 318-775-9884
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM DOUGLAS JAMES
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Credential |
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Telephone | 318-775-9870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 08023
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License Number State | LA
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