MEDICARE: DORSHENA MORRIS PITTMAN P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	00410	LA

General Provider Information

NPI Number	:	1184837973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORSHENA MORRIS PITTMAN P.T.

Provider Business Mailing Address
First Line	:	2 CADDO CT.
Second Line	:
City	:	KENNER
State	:	LA
Zip	:	70065
Country	:	US
Telephone Number	:	504-606-7538
Fax Number	:

Provider Business Practice Location Address
First Line	:	6160 LOOP 610 EAST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77087
Country	:	US
Telephone Number	:	713-640-2400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	07/08/2007

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