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General NPI Number Information
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NPI Number | 1164659538
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Entity Type | Individual
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Provider Name | JAMIE DANOS PTA
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Gender | Female
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Dates
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Enumeration Date | 06/12/2009
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Last Update Date | 06/12/2009
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Provider Practice Location Address
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Address Line | 146 EAST 28TH ST
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City | CUT OFF
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State | LA
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Zip | 70345
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Country | US
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Telephone | 985-693-8677
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Fax | 985-693-8126
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Provider Business Mailing Address
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Address Line | 140 E 114TH ST
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City | GALLIANO
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State | LA
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Zip | 70354-4122
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Country | US
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Telephone | 985-693-8677
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Fax | 985-693-8126
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A7146
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License Number State | LA
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