Provider Demographics
NPI:1699212688
Name:JBJT SERVICES, LLC
Entity Type:Organization
Organization Name:JBJT SERVICES, LLC
Other - Org Name:JOHNSON PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREME
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:318-312-1773
Mailing Address - Street 1:169 BEAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-1640
Mailing Address - Country:US
Mailing Address - Phone:318-312-1773
Mailing Address - Fax:
Practice Address - Street 1:304 E REYNOLDS DR
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-2817
Practice Address - Country:US
Practice Address - Phone:318-224-9148
Practice Address - Fax:318-314-2059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08028225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty