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NPI Code Detail

MEDICARE: REFORM PHYSICAL THERAPY, LLC

MEDICARE: REFORM PHYSICAL THERAPY, LLC
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
1225100000XPhysical Therapist08759RLA
2225100000XPhysical Therapist08758RLA

General Provider Information

NPI Number : 1568986628
Entity Type Code : Organization
Provider Name (Legal Business Name) : REFORM PHYSICAL THERAPY, LLC
Provider Business Mailing Address
First Line : PO BOX 45
Second Line :
City : BALL
State : LA
Zip : 71405-0045
Country : US
Telephone Number : 318-446-7355
Fax Number :
Provider Business Practice Location Address
First Line : 3304 MASONIC DR STE 4001
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71301-4255
Country : US
Telephone Number : 318-446-7355
Fax Number :
Authorized Official
Title or Position : OWNER, PHYSICAL THERAPIST
Name : JEREMIAH BIEHL
Credential : DPT
Telephone Number : 318-446-7355
Provider Enumeration Date : 07/31/2017
Last Update Date : 07/31/2017

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Directions to “REFORM PHYSICAL THERAPY, LLC ” Practice Location

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