Healthcare Provider Details

I. General information

NPI: 1578503082
Provider Name (Legal Business Name): ARTHUR GORMAN KIRSCH III P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5008 W ESPLANADE AVE
METAIRIE LA
70006-2551
US

IV. Provider business mailing address

2633 NAPOLEON AVE SUITE 615
NEW ORLEANS LA
70115-6357
US

V. Phone/Fax

Practice location:
  • Phone: 504-885-9675
  • Fax: 504-885-9664
Mailing address:
  • Phone: 504-895-0638
  • Fax: 504-891-5676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT06863
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: