Healthcare Provider Details

I. General information

NPI: 1669799565
Provider Name (Legal Business Name): LINDA GREEN WEINMUNSON L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2010
Last Update Date: 05/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1536 ORPHEUM AVE
METAIRIE LA
70005-1465
US

IV. Provider business mailing address

1536 ORPHEUM AVE
METAIRIE LA
70005-1465
US

V. Phone/Fax

Practice location:
  • Phone: 504-837-3690
  • Fax:
Mailing address:
  • Phone: 504-837-3690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173C00000X
TaxonomyReflexologist
License NumberLA4654
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: