Provider Demographics
NPI:1093872491
Name:OMNI THERAPY
Entity Type:Organization
Organization Name:OMNI THERAPY
Other - Org Name:PHYSICAL THERAPY SPECIALISTS OF BATON ROUGE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MACKAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-478-4471
Mailing Address - Street 1:19224 GREEN HERON DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-3972
Mailing Address - Country:US
Mailing Address - Phone:225-478-4471
Mailing Address - Fax:866-584-3939
Practice Address - Street 1:19224 GREEN HERON DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-3972
Practice Address - Country:US
Practice Address - Phone:225-478-4471
Practice Address - Fax:866-584-3939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5C746Medicare UPIN