Doctor Name: | JARRAD W FAULK |
NPI Number: | 1154377851 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 06930 |
Business Practice Address: | 3001 Armand St Ste F Monroe, LA - 712013761 |
Business Phone Number: | 3183406300 |
Business Fax Number: | 3183406323 |
Mailing Address: | 2804 Cuba Blvd, MONROE |
State: | LA |
Postal Code: | 712012014 |
Phone Number: | 3183433149 |
Fax Number: | 3183252022 |
NPI Enumeration Date: | 05/25/2006 |
NPI Last Update Date: | 06/03/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 06930 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |