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NPI Code Detail

MEDICARE: MR. J J ALLEN LMT

MEDICARE: MR. J J ALLEN LMT
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
1225700000XMassage TherapistLA2069-01LA

General Provider Information

NPI Number : 1811046055
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. J J ALLEN LMT
Provider Business Mailing Address
First Line : 15076 PALM POINTE AVE
Second Line :
City : GONZALES
State : LA
Zip : 70737-9998
Country : US
Telephone Number : 225-622-0201
Fax Number :
Provider Business Practice Location Address
First Line : 4701 BLUEBONNET BLVD
Second Line : SUITE B
City : BATON ROUGE
State : LA
Zip : 70809-9635
Country : US
Telephone Number : 225-291-2626
Fax Number : 225-291-2628
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2007
Last Update Date : 07/08/2007

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