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NPI Code Detail

MEDICARE: HOGAN THERAPY ASSOCIATES INC.

MEDICARE: HOGAN THERAPY ASSOCIATES 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 Therapist06610LA

General Provider Information

NPI Number : 1669493797
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOGAN THERAPY ASSOCIATES INC.
Provider Business Mailing Address
First Line : 1123 FORSYTHE AVE
Second Line :
City : MONROE
State : LA
Zip : 71201-4307
Country : US
Telephone Number : 318-322-9980
Fax Number : 318-322-9946
Provider Business Practice Location Address
First Line : 1123 FORSYTHE AVE
Second Line :
City : MONROE
State : LA
Zip : 71201-4307
Country : US
Telephone Number : 318-322-9980
Fax Number : 318-322-9946
Authorized Official
Title or Position : PHYSICAL THERAPIST/ OWNER
Name : MR. BRENTLY SHANE HOGAN
Credential : PT, DPT
Telephone Number : 318-322-9980
Provider Enumeration Date : 07/22/2006
Last Update Date : 11/28/2007

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Directions to “HOGAN THERAPY ASSOCIATES INC. ” Practice Location

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