Healthcare Provider Details

I. General information

NPI: 1902827082
Provider Name (Legal Business Name): LOUISIANA PHYSICAL THERAPY CENTERS OF OAKDALE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 04/13/2020
Certification Date: 04/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 E 5TH AVE STE A
OAKDALE LA
71463-2903
US

IV. Provider business mailing address

205 E 5TH AVE STE A
OAKDALE LA
71463-2903
US

V. Phone/Fax

Practice location:
  • Phone: 318-335-3125
  • Fax: 318-335-3394
Mailing address:
  • Phone: 318-335-3125
  • Fax: 318-335-3394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: STEVEN C JONES
Title or Position: OWNER
Credential: PT
Phone: 318-335-3125