Provider Demographics
NPI:1104458686
Name:STERLINGTON PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:STERLINGTON PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:BRITTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-325-6200
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:LA
Mailing Address - Zip Code:71240-0127
Mailing Address - Country:US
Mailing Address - Phone:318-503-9789
Mailing Address - Fax:318-267-0131
Practice Address - Street 1:8649 HIGHWAY 165 N STE 5
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-8965
Practice Address - Country:US
Practice Address - Phone:318-503-9789
Practice Address - Fax:318-267-0131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-12
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty