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General NPI Number Information
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NPI Number | 1497059075
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Entity Type | Individual
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Provider Name | MRS. JENNIFER K FUSELIER
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Gender | Female
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Dates
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Enumeration Date | 12/22/2010
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Last Update Date | 12/22/2010
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Provider Practice Location Address
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Address Line | 2002 JOHNSON ST STE. 100
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City | JENNINGS
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State | LA
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Zip | 70546-3640
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Country | US
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Telephone | 337-824-4547
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Fax | 337-824-4548
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Provider Business Mailing Address
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Address Line | 13418 HIGHWAY 190
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City | KINDER
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State | LA
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Zip | 70648-5437
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Country | US
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Telephone | 337-526-0154
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Fax | 337-824-4548
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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 | 00862
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License Number State | LA
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