Healthcare Provider Details

I. General information

NPI: 1851164495
Provider Name (Legal Business Name): ERIK LANE PATTERSON PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 W MINNESOTA PARK RD STE A
HAMMOND LA
70403-6149
US

IV. Provider business mailing address

389 HIGHWAY 21 STE 403
MADISONVILLE LA
70447-3441
US

V. Phone/Fax

Practice location:
  • Phone: 985-549-1900
  • Fax: 985-549-1888
Mailing address:
  • Phone: 985-792-5996
  • Fax: 985-792-5998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11671
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: