MEDICARE: DR. DENISE RAE GERRITY 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	10443R	LA

General Provider Information

NPI Number	:	1346826393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENISE RAE GERRITY DPT

Provider Business Mailing Address
First Line	:	7054 CRESWELL RD
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-4713
Country	:	US
Telephone Number	:	256-508-9129
Fax Number	:

Provider Business Practice Location Address
First Line	:	1935 E 70TH ST
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-0003
Country	:	US
Telephone Number	:	318-408-1799
Fax Number	:

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

Provider Enumeration Date	:	03/21/2021
Last Update Date	:	04/26/2025

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