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NPI Code Detail

MEDICARE: MR. LAUDREY BROWNELL CODY III DPT

MEDICARE: MR. LAUDREY BROWNELL CODY III DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
109029OTHERPT STATE LICENSE

General Provider Information

NPI Number : 1992182430
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LAUDREY BROWNELL CODY III DPT
Provider Business Mailing Address
First Line : 4621 WEST NAPOLEON AVENUE
Second Line : SUITE #101
City : METAIRIE
State : LA
Zip : 70001-2478
Country : US
Telephone Number : 504-889-1193
Fax Number : 504-889-1194
Provider Business Practice Location Address
First Line : 4621 WEST NAPOLEON AVENUE
Second Line : SUITE #101
City : METAIRIE
State : LA
Zip : 70001-2478
Country : US
Telephone Number : 504-889-1193
Fax Number : 504-889-1194
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2015
Last Update Date : 05/05/2015

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