| Organization Name: | AMITE PHYSICAL THERAPY DBA PROFESSIONAL PHYSICAL THERAPY |
| NPI Number: | 1083761266 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARVIN BRUCE NEAL (PRESIDENT) |
| Mailing Address: | 216 N 2nd St Amite |
| State: | LA US |
| Postal Code: | 704222408 |
| Phone Number: | 9857487878 |
| Fax Number: | 9857482837 |
| NPI Enumeration Date: | 01/03/2007 |
| NPI Last Update Date: | 01/29/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | 140 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |