| NPI | 1114093507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER JANNISE Office Manager 337-594-0038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 00766) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2007-08-30 |