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General NPI Number Information
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NPI Number | 1669524195
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Entity Type | Organization
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Legal Business Name | LANDERS PHYSICAL THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 10/12/2007
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Provider Practice Location Address
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Address Line | 1010 S POLK ST SUITE 2
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City | COVINGTON
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State | LA
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Zip | 70433-2474
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Country | US
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Telephone | 985-809-9088
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Fax | 985-809-9270
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Provider Business Mailing Address
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Address Line | 1010 S POLK ST SUITE 2
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City | COVINGTON
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State | LA
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Zip | 70433-2474
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Country | US
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Telephone | 985-809-9088
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Fax | 985-809-9270
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Authorized Official
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Title or Position | DOCTOR OF PHYSICAL THERAPY
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Name | DR. P.J. LANDERS
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Credential | DPT, MTC, OCS
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Telephone | 985-809-9088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT04633
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License Number State | LA
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