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General NPI Number Information
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NPI Number | 1568404630
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Entity Type | Individual
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Provider Name | JAMES T FONTENOT PT
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Gender | Male
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 433 JACK MILLER RD
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City | VILLE PLATTE
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State | LA
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Zip | 70586-5635
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Country | US
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Telephone | 337-363-0095
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Fax | 337-363-5497
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Provider Business Mailing Address
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Address Line | PO BOX 822
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City | VILLE PLATTE
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State | LA
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Zip | 70586-0822
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Country | US
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Telephone | 337-363-0095
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Fax | 337-363-5497
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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 | PT0440
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License Number State | LA
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