MEDICARE: CARRIE DELUCA GLAHN DPT

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	08394	LA

General Provider Information

NPI Number	:	1548676174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE DELUCA GLAHN DPT

Provider Business Mailing Address
First Line	:	2033 N HIGHWAY 190 STE 10
Second Line	:
City	:	COVINGTON
State	:	LA
Zip	:	70433-8985
Country	:	US
Telephone Number	:	985-792-7700
Fax Number	:

Provider Business Practice Location Address
First Line	:	2033 N HIGHWAY 190 STE 10
Second Line	:
City	:	COVINGTON
State	:	LA
Zip	:	70433-8985
Country	:	US
Telephone Number	:	985-590-4549
Fax Number	:

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

Provider Enumeration Date	:	07/02/2014
Last Update Date	:	05/22/2024

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