MEDICARE: ALFIE DULAP PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	07507F	LA

General Provider Information

NPI Number	:	1013775535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALFIE DULAP PT, DPT

Provider Business Mailing Address
First Line	:	4430 BROWN ST APT F
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70607-4768
Country	:	US
Telephone Number	:	646-491-2718
Fax Number	:

Provider Business Practice Location Address
First Line	:	4430 BROWN ST APT F
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70607-4768
Country	:	US
Telephone Number	:	646-491-2718
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2024
Last Update Date	:	03/08/2024

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