Provider Demographics
NPI: | 1003178393 |
---|---|
Name: | CITY PARK PHYSICAL THERAPY, LLC |
Entity Type: | Organization |
Organization Name: | CITY PARK PHYSICAL THERAPY, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | VICE PRESIDENT |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | CHERIE |
Authorized Official - Middle Name: | CHATELAIN |
Authorized Official - Last Name: | ROSE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OT |
Authorized Official - Phone: | 504-309-5811 |
Mailing Address - Street 1: | 5559 CANAL BOULEVARD |
Mailing Address - Street 2: | |
Mailing Address - City: | NEW ORLEANS |
Mailing Address - State: | LA |
Mailing Address - Zip Code: | 70124-2745 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 504-309-5811 |
Mailing Address - Fax: | 504-309-5877 |
Practice Address - Street 1: | 5559 CANAL BLVD. |
Practice Address - Street 2: | |
Practice Address - City: | NEW ORLEANS |
Practice Address - State: | LA |
Practice Address - Zip Code: | 70124-2745 |
Practice Address - Country: | US |
Practice Address - Phone: | 504-309-5811 |
Practice Address - Fax: | 504-309-5877 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-06-12 |
Last Update Date: | 2013-08-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | Group - Multi-Specialty | |
No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
No | 171100000X | Other Service Providers | Acupuncturist | Group - Multi-Specialty | |
No | 224Y00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Clinical Exercise Physiologist | Group - Multi-Specialty | |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
No | 2255A2300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer | Group - Multi-Specialty |
No | 225700000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |