Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. DWIGHT A TIETJEN JR., P.T.
Active Sole ProprietorMR. DWIGHT A TIETJEN JR., P.T. is a Physical Therapy Assistant healthcare provider located in SHREVEPORT, Louisiana. NPI 1902001076 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · SHREVEPORT, LA
Registration Details
- NPI Number
- 1902001076
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 19, 2007 (19.147136616743 yrs)
- Last Updated
- Jul 8, 2007
- License
-
PT118 (LA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4801 CRESCENT DRSHREVEPORT, LA, 711061807Browse LA providers · Browse ZIP 71106
- Phone
- 3184640553
- Primary Specialty
-
Physical Therapy Assistant
225100000X
Other Physical Therapy Assistant Providers in SHREVEPORT, LA
| Name | Credential | NPI |
|---|---|---|
| MARTIN S YOUNG | L.P.T. | 1407854367 |
| MR. LARRY NELS LARSEN | P.T., A.T.C., S.T.S. | 1497740088 |
| TERRY L EBERHARDT | PT | 1558358101 |
| LINDSAY TURNER CARADONNA | PT | 1265408868 |
| MR. JASON RILEY | MPT, ATC, LAT, CKTP | 1861444200 |
| DR. GREGORY JAMES REDMOND | DPT | 1407894355 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.