Provider Demographics
NPI:1447452974
Name:PIERRE PART PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:PIERRE PART PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAINE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:985-252-9396
Mailing Address - Street 1:2729 LEE DR
Mailing Address - Street 2:
Mailing Address - City:PIERRE PART
Mailing Address - State:LA
Mailing Address - Zip Code:70339-4935
Mailing Address - Country:US
Mailing Address - Phone:985-252-9396
Mailing Address - Fax:985-252-9396
Practice Address - Street 1:2729 LEE DR
Practice Address - Street 2:
Practice Address - City:PIERRE PART
Practice Address - State:LA
Practice Address - Zip Code:70339-4935
Practice Address - Country:US
Practice Address - Phone:985-252-9396
Practice Address - Fax:985-252-9396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT00280261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5X188OtherMEDICARE ID