Healthcare Provider Details

I. General information

NPI: 1164526174
Provider Name (Legal Business Name): BONE & JOINT PHYSICAL THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4633 WICHERS DR
MARRERO LA
70072-3002
US

IV. Provider business mailing address

4633 WICHERS DR
MARRERO LA
70072-3002
US

V. Phone/Fax

Practice location:
  • Phone: 504-347-0733
  • Fax: 504-378-9329
Mailing address:
  • Phone: 504-347-0733
  • Fax: 504-378-9329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL J GALLAGHER
Title or Position: CORP OFFICER
Credential: MD
Phone: 504-347-5421