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NPI Code Detail

MEDICARE: PONCHATOULA THERAPY

MEDICARE: PONCHATOULA THERAPY
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
2225100000XPhysical Therapist

General Provider Information

NPI Number : 1922398544
Entity Type Code : Organization
Provider Name (Legal Business Name) : PONCHATOULA THERAPY
Provider Business Mailing Address
First Line : 132 S 6TH ST
Second Line :
City : PONCHATOULA
State : LA
Zip : 70454-3317
Country : US
Telephone Number : 985-969-0517
Fax Number :
Provider Business Practice Location Address
First Line : 132 S 6TH ST
Second Line :
City : PONCHATOULA
State : LA
Zip : 70454-3317
Country : US
Telephone Number : 985-969-0517
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : CARRIE C HIGGS
Credential : LOTR
Telephone Number : 985-969-0517
Provider Enumeration Date : 04/15/2011
Last Update Date : 08/16/2021

Similar Medicare Providers

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Practice Location Address:
132 S 6TH ST
PONCHATOULA, LA
70454-3317
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1922278050 — SCOTT HUNTER HIGGS P.T.
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1922235969 — MS. AMY E FORREST M.S., CCC-SLP
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Practice Fax:
1861781478 — CARRIE L HIGGS LOTR
Practice Location Address:
132 S 6TH ST
PONCHATOULA, LA
70454-3317
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1386086494 — SUSAN M TODD M.S., CCC-SLP
Practice Location Address:
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70454-3317
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1417472416 — MALLORY KRAFT
Practice Location Address:
132 S 6TH ST
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Practice Fax:

Directions to “PONCHATOULA THERAPY ” Practice Location

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