| Dr Nicholas R Fulco, DPT | |
|
502 Anderson Ave, Shreveport, LA 71104-3602 | |
| (318) 200-0386 | |
| (866) 825-4104 |
| Full Name | Dr Nicholas R Fulco |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 502 Anderson Ave, Shreveport, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760006803 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 10556 (Louisiana) | Primary |
| Provider Name | Fulco And Hall Performance And Therapy Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1114790177 PECOS PAC ID: 7315489960 Enrollment ID: O20240611001111 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Nicholas R Fulco, DPT 6123 Kateland Cir, Bossier City, LA 71111-6988 Ph: (318) 754-7367 | Dr Nicholas R Fulco, DPT 502 Anderson Ave, Shreveport, LA 71104-3602 Ph: (318) 200-0386 |
Suzannah Kathryn York - Crump, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 266 Ockley Dr, Shreveport, LA 71105 Phone: 337-580-0083 Fax: 337-580-0083 | |
Anna Means Moore, PT, DPT, OCS Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2950 Fairfield Ave, Shreveport, LA 71104 Phone: 318-841-0696 Fax: 318-841-0776 | |
Sydney Williams, Physical Therapist Medicare: Medicare Enrolled Practice Location: 670 Albemarle Dr Ste 1100, Shreveport, LA 71106 Phone: 318-828-1450 Fax: 318-828-2697 | |
Archna Shasta, Physical Therapist Medicare: Medicare Enrolled Practice Location: 7591 Fern Ave Ste 1203, Shreveport, LA 71105 Phone: 318-828-2972 | |
Claire Marie Melebeck, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1450 Claiborne Ave, School Of Allied Health, Shreveport, LA 71103 Phone: 318-813-2961 Fax: 318-813-2989 | |
Michael Wayne Wiltcher, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 10178 Berrywood Cir, Shreveport, LA 71106 Phone: 318-469-4349 | |
Dr. Courtney E Page, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6969 Fern Loop Ste A, Shreveport, LA 71105 Phone: 317-383-0022 |