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General NPI Number Information
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NPI Number | 1275025538
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Entity Type | Organization
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Legal Business Name | CATALYST PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 06/02/2018
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Last Update Date | 07/26/2018
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Provider Practice Location Address
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Address Line | 6824 VETERANS BLVD STE 100
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City | METAIRIE
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State | LA
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Zip | 70003
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Country | US
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Telephone | 504-301-0061
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Fax | 504-301-0062
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Provider Business Mailing Address
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Address Line | 9629 MARSHA DR
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City | RIVER RIDGE
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State | LA
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Zip | 70123-2009
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | MR. CRAIG DAUTERIVE
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Credential |
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Telephone | 504-390-2076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 08071
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License Number State | LA
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