MEDICARE: FUNCTIONAL CAPACITY EXPERTS, L.L.C.

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	261QP2000X	Physical Therapy Clinic/Center	01827	LA
2	2251X0800X	Orthopedic Physical Therapist	01827	LA

General Provider Information

NPI Number	:	1073844486
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FUNCTIONAL CAPACITY EXPERTS, L.L.C.

Provider Business Mailing Address
First Line	:	1613 JIMMIE DAVIS HWY
Second Line	:	SUITE 400
City	:	BOSSIER CITY
State	:	LA
Zip	:	71112-4557
Country	:	US
Telephone Number	:	318-658-5800
Fax Number	:

Provider Business Practice Location Address
First Line	:	1613 JIMMIE DAVIS HWY
Second Line	:	SUITE 400
City	:	BOSSIER CITY
State	:	LA
Zip	:	71112-4557
Country	:	US
Telephone Number	:	318-658-5800
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEVE V ALLISON
Credential	:	D.P.T.
Telephone Number	:	318-658-5800

Provider Enumeration Date	:	01/25/2010
Last Update Date	:	01/25/2010

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