MEDICARE: RIVERBEND PHYSICAL THERAPY, LLC

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1427560721
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERBEND PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	3409 DIVISION ST STE 202
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70002-4611
Country	:	US
Telephone Number	:	504-603-6044
Fax Number	:

Provider Business Practice Location Address
First Line	:	3409 DIVISION ST STE 202
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70002-4611
Country	:	US
Telephone Number	:	504-603-6044
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	BRENT ROBERTSON
Credential	:	PT
Telephone Number	:	504-628-8085

Provider Enumeration Date	:	10/26/2017
Last Update Date	:	11/06/2023

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