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NPI Code Detail

MEDICARE: SARAH KAITLENN LACOSTE PT

MEDICARE:   SARAH KAITLENN LACOSTE  PT
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 TherapistPT7057MS
2225100000XPhysical TherapistCP015382TLA

General Provider Information

NPI Number : 1659966059
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH KAITLENN LACOSTE PT
Provider Business Mailing Address
First Line : 1151 BARATARIA BLVD STE 4300
Second Line :
City : MARRERO
State : LA
Zip : 70072-3084
Country : US
Telephone Number : 504-340-6976
Fax Number : 504-349-6786
Provider Business Practice Location Address
First Line : 1151 BARATARIA BLVD STE 4300
Second Line :
City : MARRERO
State : LA
Zip : 70072-3084
Country : US
Telephone Number : 504-340-6976
Fax Number : 504-349-6786
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2021
Last Update Date : 10/14/2022

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Directions to “ SARAH KAITLENN LACOSTE PT” Practice Location

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