=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407700636
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PELVIC HARMONY PT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/24/2026
-----------------------------------------------------
Last Update Date | 02/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 340 BRAKEFIELD ST
-----------------------------------------------------
City | SLIDELL
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70458-3620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-265-7364
-----------------------------------------------------
Fax | 985-529-8304
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 340 BRAKEFIELD ST
-----------------------------------------------------
City | SLIDELL
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70458-3620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-265-7364
-----------------------------------------------------
Fax | 985-529-8304
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/THERAPIST
-----------------------------------------------------
Name | LACY NICOLE SANTANA
-----------------------------------------------------
Credential | DPT
-----------------------------------------------------
Telephone | 985-265-7364
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------