=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144957358
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HAO LIU PHYSICAL THERAPY
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2022
-----------------------------------------------------
Last Update Date | 11/01/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1900 GRAVIER ST FL 7
-----------------------------------------------------
City | NEW ORLEANS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70112-2262
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-568-4288
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1900 GRAVIER ST FL 7
-----------------------------------------------------
City | NEW ORLEANS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70112-2262
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-568-4042
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2251G0304X
-----------------------------------------------------
Taxonomy Name | Geriatric Physical Therapist
-----------------------------------------------------
License Number | 04878
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------