Healthcare Provider Details

I. General information

NPI: 1194805341
Provider Name (Legal Business Name): NELDA F PERRY PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2204 ROBIN AVE
HAMMOND LA
70403-5751
US

IV. Provider business mailing address

P O BOX 2965
HAMMOND LA
70404
US

V. Phone/Fax

Practice location:
  • Phone: 985-542-7878
  • Fax: 985-542-4396
Mailing address:
  • Phone: 985-542-7878
  • Fax: 985-542-4396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA7016
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: