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General NPI Number Information
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NPI Number | 1851597348
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Entity Type | Organization
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Legal Business Name | NORTHSHORE THERAPY CENTER, LLC
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2800 GAUSE BLVD E
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City | SLIDELL
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State | LA
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Zip | 70461-4247
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Country | US
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Telephone | 985-643-4263
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Fax | 985-643-4774
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Provider Business Mailing Address
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Address Line | 2800 GAUSE BLVD E
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City | SLIDELL
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State | LA
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Zip | 70461-4247
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Country | US
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Telephone | 985-643-4263
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Fax | 985-643-4774
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Authorized Official
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Title or Position | PRESIDENT
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Name | AMANDA MILLER
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Credential | MOT, LOTR
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Telephone | 985-643-4263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | OTT.200062
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | OTT.200062
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License Number State | LA
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