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NPI Code Detail

MEDICARE: THERA-PAX ENTERPRISES, INC.

MEDICARE: THERA-PAX ENTERPRISES, INC.
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
1225100000XPhysical Therapist06735RLA

General Provider Information

NPI Number : 1457486623
Entity Type Code : Organization
Provider Name (Legal Business Name) : THERA-PAX ENTERPRISES, INC.
Provider Business Mailing Address
First Line : 1123 FORSYTHE AVE
Second Line :
City : MONROE
State : LA
Zip : 71201-4307
Country : US
Telephone Number : 318-324-1592
Fax Number : 318-324-1593
Provider Business Practice Location Address
First Line : 1123 FORSYTHE AVE
Second Line :
City : MONROE
State : LA
Zip : 71201-4307
Country : US
Telephone Number : 318-324-1592
Fax Number : 318-324-1593
Authorized Official
Title or Position : OWNER
Name : MR. BRIAN S PAXTON
Credential : PT, DPT
Telephone Number : 318-324-1592
Provider Enumeration Date : 02/21/2007
Last Update Date : 08/22/2020

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Directions to “THERA-PAX ENTERPRISES, INC. ” Practice Location

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