Superior Spine and Sports Physical Therapy INC
NPI #1619681772 in Lake Charles, Louisiana
Provider Information
- NPI Number
- 1619681772
- Entity Type
- Organization
- Organization Name
- Superior Spine and Sports Physical Therapy INC
- Primary Specialty
- Physical Therapist
- Enumeration Date
- Jan 12, 2023
- Last Updated
- Jan 12, 2023
Practice Location
- Address
- 5750 LAKE STREET
- Address 2
- SUITE 100
- City
- Lake Charles
- State
- Louisiana
- ZIP Code
- 70605
- Phone
- (337) 513-7107
Authorized Official
- Name
- KOURTNEY ELLIS, DPT
- Title
- CO-OWNER
- Phone
- (337) 513-7107
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
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