Healthcare Provider Details

I. General information

NPI: 1083243513
Provider Name (Legal Business Name): PARISH PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 10/05/2021
Certification Date: 10/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 CAMERON ST
SCOTT LA
70583-5144
US

IV. Provider business mailing address

109 THOMAS OAK DR
CHURCH POINT LA
70525-5916
US

V. Phone/Fax

Practice location:
  • Phone: 337-523-2279
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JESSICA SIMON JIMENEZ
Title or Position: MANAGER/OWNER
Credential:
Phone: 337-523-2279