Provider Demographics
NPI:1013775535
Name:DULAP, ALFIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALFIE
Middle Name:
Last Name:DULAP
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4430 BROWN ST APT F
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-4768
Mailing Address - Country:US
Mailing Address - Phone:646-491-2718
Mailing Address - Fax:
Practice Address - Street 1:4430 BROWN ST APT F
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-4768
Practice Address - Country:US
Practice Address - Phone:646-491-2718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07507F225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty