MEDICARE: UNITED PAIN PRACTITIONERS, 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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1588652333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED PAIN PRACTITIONERS, LLC

Provider Business Mailing Address
First Line	:	2448 JOHNSTON ST
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-2756
Country	:	US
Telephone Number	:	337-261-5151
Fax Number	:

Provider Business Practice Location Address
First Line	:	2448 JOHNSTON ST
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-2756
Country	:	US
Telephone Number	:	337-261-5151
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PT
Name	:	ANTHONY QUINN
Credential	:	PT
Telephone Number	:	337-261-5151

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	09/28/2007

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Directions to “UNITED PAIN PRACTITIONERS, LLC ” Practice Location

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