| NPI | 1720031222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL THOMAS FORESTER Owner / President 318-445-4455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 04559) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2020-08-22 |