Provider Demographics
NPI:1487544854
Name:OZANE, CLOVIS JAMES JR (PT)
Entity type:Individual
Prefix:MR
First Name:CLOVIS
Middle Name:JAMES
Last Name:OZANE
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 POMEROY DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71115-2612
Mailing Address - Country:US
Mailing Address - Phone:337-304-3547
Mailing Address - Fax:
Practice Address - Street 1:4828 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71112-4244
Practice Address - Country:US
Practice Address - Phone:318-746-0470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07265225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist