Mr Larry Nels Larsen, PT, ATC, STS | |
1717 Irving Pl, Shreveport, LA 71101-4605 | |
(318) 425-5604 | |
(318) 222-8165 |
Full Name | Mr Larry Nels Larsen |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 1717 Irving Pl, Shreveport, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497740088 | NPI | - | NPPES |
1112143 | Medicaid | LA | |
0321 | Other | LA | PHYSICAL THERAPY LICENSE# |
52161 | Other | LA | BC/BS OF LA INDIVIDUAL # |
00321 | Other | LA | F A RICHARDS INSURANCE |
09098 | Other | LA | BC/BS OF LA GROUP # |
220610 | Other | LA | METLIFE HEALTH CARE |
PT0321 | Other | LA | CLAIMS MANAGEMENT INC. |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 0321 (Louisiana) | Primary |
Provider Name | Brewer Physical Therapy & Associates Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1477709681 PECOS PAC ID: 9931275419 Enrollment ID: O20080908000005 |
Mailing Address | Practice Location Address |
---|---|
Mr Larry Nels Larsen, PT, ATC, STS 1717 Irving Pl, Shreveport, LA 71101-4605 Ph: (318) 425-5604 | Mr Larry Nels Larsen, PT, ATC, STS 1717 Irving Pl, Shreveport, LA 71101-4605 Ph: (318) 425-5604 |
Suzannah Kathryn York - Crump, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 266 Ockley Dr, Shreveport, LA 71105 Phone: 337-580-0083 Fax: 337-580-0083 | |
Anna Means Moore, PT, DPT, OCS Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2950 Fairfield Ave, Shreveport, LA 71104 Phone: 318-841-0696 Fax: 318-841-0776 | |
Sydney Williams, Physical Therapist Medicare: Medicare Enrolled Practice Location: 670 Albemarle Dr Ste 1100, Shreveport, LA 71106 Phone: 318-828-1450 Fax: 318-828-2697 | |
Archna Shasta, Physical Therapist Medicare: Medicare Enrolled Practice Location: 7591 Fern Ave Ste 1203, Shreveport, LA 71105 Phone: 318-828-2972 | |
Eberhardt Physical Therapy & Wellness Clinic, Inc. Physical Therapist Medicare: Medicare Enrolled Practice Location: 820 Jordan St Ste 150, Shreveport, LA 71101 Phone: 318-222-7442 Fax: 318-424-4751 | |
Claire Marie Melebeck, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1450 Claiborne Ave, School Of Allied Health, Shreveport, LA 71103 Phone: 318-813-2961 Fax: 318-813-2989 | |
Michael Wayne Wiltcher, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 10178 Berrywood Cir, Shreveport, LA 71106 Phone: 318-469-4349 |