Provider Demographics
NPI:1346826393
Name:JOPLIN, DENISE RAE GERRITY (DPT)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:RAE GERRITY
Last Name:JOPLIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7607 FERN AVE STE 704
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5744
Mailing Address - Country:US
Mailing Address - Phone:318-828-1450
Mailing Address - Fax:318-828-2697
Practice Address - Street 1:7607 FERN AVE STE 704
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5744
Practice Address - Country:US
Practice Address - Phone:318-828-1450
Practice Address - Fax:318-828-2697
Is Sole Proprietor?:No
Enumeration Date:2021-03-21
Last Update Date:2021-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10443R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist