NPI 1124499751

Sportmedica, LLC

Organisation Rehabilitation Hospital Shreveport, LA

Practice location

Address: 2934 Chardonnay Cir, Shreveport, LA 71106-8418
Phone: (318) 458-8490

Authorised official

Name: William Overdyke
Title: Medical Physician/ Owner
Phone: (318) 458-8490

Registered specialties

Rehabilitation Hospital Primary

Hospitals Taxonomy 283X00000X Licence MD.014596 (LA)

Other Rehabilitation Hospital providers in Louisiana →

Registry record

NPI: 1124499751
Entity type: Organization
NPI issued: 8 Oct 2015
Record last updated: 8 Oct 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.