| NPI | 1962624353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE A PAVICH Owner 225-939-0228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: LA PT00594) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |