Provider Demographics
NPI:1831595677
Name:QUAD C PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:QUAD C PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:V
Authorized Official - Last Name:BYLES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:318-256-0660
Mailing Address - Street 1:720 SHREVEPORT HWY
Mailing Address - Street 2:
Mailing Address - City:MANY
Mailing Address - State:LA
Mailing Address - Zip Code:71449-2612
Mailing Address - Country:US
Mailing Address - Phone:318-256-5430
Mailing Address - Fax:318-256-5432
Practice Address - Street 1:326 FISHER RD
Practice Address - Street 2:
Practice Address - City:MANY
Practice Address - State:LA
Practice Address - Zip Code:71449-3833
Practice Address - Country:US
Practice Address - Phone:318-256-0660
Practice Address - Fax:318-256-0661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy