Healthcare Provider Details
I. General information
NPI: 1487604096
Provider Name (Legal Business Name): BENETH MARIE FRAME PT, MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/12/2006
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
484 ALBERTSON PKWY STE A
BROUSSARD LA
70518-4968
US
IV. Provider business mailing address
1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US
V. Phone/Fax
- Phone: 337-839-8883
- Fax: 337-839-8939
- Phone: 423-238-7217
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 04958 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: