| NPI | 1447851878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA LYNN CALLAIS Owner 985-276-4095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2025-07-07 |