Provider Demographics
NPI:1083884639
Name:PORCHE, ROBERT A (PT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:A
Last Name:PORCHE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 HOUMA BLVD
Mailing Address - Street 2:SUITE 17
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2931
Mailing Address - Country:US
Mailing Address - Phone:504-885-9121
Mailing Address - Fax:504-885-0322
Practice Address - Street 1:3939 HOUMA BLVD
Practice Address - Street 2:SUITE 17
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2931
Practice Address - Country:US
Practice Address - Phone:504-885-9121
Practice Address - Fax:504-885-0322
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA035222251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic