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General NPI Number Information
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NPI Number | 1750514113
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Entity Type | Organization
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Legal Business Name | LA HEALTH CENTERS, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/01/2009
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | 32350 LA HIGHWAY 16 BLDG C
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-1463
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Country | US
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Telephone | 225-664-1456
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Fax |
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Provider Business Mailing Address
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Address Line | 32350 LA HIGHWAY 16 BLDG C
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-1463
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Country | US
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Telephone | 225-664-1456
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHIE REED ROTH
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Credential | D.C.
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Telephone | 225-664-1456
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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 | 04489R
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License Number State | LA
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