Healthcare Provider Details

I. General information

NPI: 1316083447
Provider Name (Legal Business Name): MAGNOLIA PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5606 JEFFERSON HWY
HARAHAN LA
70123-5111
US

IV. Provider business mailing address

5606 JEFFERSON HWY
HARAHAN LA
70123-5111
US

V. Phone/Fax

Practice location:
  • Phone: 504-733-0254
  • Fax: 504-734-8869
Mailing address:
  • Phone: 504-733-0254
  • Fax: 504-734-8869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELIZABETH WINKLER-SCHMIT
Title or Position: OWNER
Credential: FAAOMPT
Phone: 504-733-0254