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NPI Code Detail

MEDICARE: EVOLVE PHYSICAL THERAPY AND SPORTS

MEDICARE: EVOLVE PHYSICAL THERAPY AND SPORTS
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
1261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1902378987
Entity Type Code : Organization
Provider Name (Legal Business Name) : EVOLVE PHYSICAL THERAPY AND SPORTS
Provider Business Mailing Address
First Line : 2334 UNIVERSITY CLUB DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70810-0441
Country : US
Telephone Number : 225-931-8269
Fax Number :
Provider Business Practice Location Address
First Line : 215 STARING LN
Second Line :
City : BATON ROUGE
State : LA
Zip : 70810-4064
Country : US
Telephone Number : 225-931-8269
Fax Number :
Authorized Official
Title or Position : OWNER/PHYSICAL THERAPIST
Name : MR. ROBERT JOEL BOLTON
Credential : PT
Telephone Number : 225-931-8269
Provider Enumeration Date : 01/01/2019
Last Update Date : 01/01/2019

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Directions to “EVOLVE PHYSICAL THERAPY AND SPORTS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.