Shreveport Aquatic and Land Physical Therapy. LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SHREVEPORT AQUATIC AND LAND PHYSICAL THERAPY. LLC

Practice address

6969 Fern Loop
Shreveport, LA 71105-4159

Phone

(214) 295-6703

NPI assigned

Mar 21, 2018

Last updated

May 11, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Aaron Blick

Title

Ceo

Phone

(214) 295-6703

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525996800000",
    "number": "1134623457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6969 FERN LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6969 FERN LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054159",
            "telephone_number": "214-295-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHREVEPORT AQUATIC AND LAND PHYSICAL THERAPY. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-21",
        "last_updated": "2018-05-11",
        "status": "A",
        "authorized_official_last_name": "BLICK",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-295-6703"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shoulders of Strength, Inc
• MD Manjurul Islam Shourav
• Taylor Shows
• Shreveport Anesthesia Providers LLC
• Shreveport Anesthesia Services
• Shreveport Behavioral Health Clinic
• Shreveport Center for Oral and Facial Surgery, L.L.C.
• Shreveport Chiropractic
• Shreveport Diabetic Shoes,LLC
• Shreveport Doctors Hospital 2003, LTD.

• Physical Therapist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.