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General NPI Number Information
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NPI Number | 1043259005
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Entity Type | Organization
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Legal Business Name | CRESCENT CITY PHYSICAL THERAPY
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 08/02/2010
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Provider Practice Location Address
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Address Line | 2633 NAPOLEON AVE SUITE 615
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City | NEW ORLEANS
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State | LA
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Zip | 70115-6357
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Country | US
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Telephone | 504-895-0638
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Fax | 504-891-5676
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Provider Business Mailing Address
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Address Line | 2633 NAPOLEON AVE SUITE 615
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City | NEW ORLEANS
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State | LA
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Zip | 70115-6357
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Country | US
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Telephone | 504-895-0638
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Fax | 504-891-5676
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Authorized Official
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Title or Position | PRESIDENT
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Name | VIRGINIA B DAVIS
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Credential | P.TP
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Telephone | 504-895-0638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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