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General NPI Number Information
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NPI Number | 1497033831
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Entity Type | Organization
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Legal Business Name | BATON ROUGE ORTHOPAEDIC CLINIC, LLC
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Dates
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Enumeration Date | 08/03/2011
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Last Update Date | 11/23/2011
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Provider Practice Location Address
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Address Line | 625 S BURNSIDE AVE UNIT 9
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City | GONZALES
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State | LA
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Zip | 70737-3400
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Country | US
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Telephone | 225-644-8510
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Fax |
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Provider Business Mailing Address
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Address Line | 8080 BLUEBONNET BLVD SUITE 1000
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City | BATON ROUGE
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State | LA
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Zip | 70810-7827
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Country | US
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Telephone | 225-924-2424
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Fax | 225-408-7984
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Authorized Official
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Title or Position | CEO
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Name | TREY WILLIAMSON
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Credential |
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Telephone | 225-924-2424
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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 |
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License Number State |
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