Organization Name: | PHYSICAL THERAPY CLINIC OF VINTON LLC |
NPI Number: | 1316264153 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEPHANIE MARCEAUX (OWNER/PHYSICAL THERAPIST) |
Mailing Address: | 1329a Horridge St Vinton |
State: | LA US |
Postal Code: | 706684531 |
Phone Number: | 3375892626 |
Fax Number: | 3375892621 |
NPI Enumeration Date: | 05/03/2010 |
NPI Last Update Date: | 06/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | PT02051 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |