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General NPI Number Information
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NPI Number | 1407894355
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Entity Type | Individual
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Provider Name | GREGORY JAMES REDMOND DPT
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Gender | Male
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 820 JORDAN ST STE 150
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City | SHREVEPORT
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State | LA
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Zip | 71101-4529
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Country | US
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Telephone | 318-344-1840
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Fax | 800-959-0163
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Provider Business Mailing Address
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Address Line | 820 JORDAN ST STE 150
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City | SHREVEPORT
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State | LA
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Zip | 71101-4529
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Country | US
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Telephone | 318-222-7442
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Fax | 318-424-4751
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 05083
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License Number State | LA
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