Provider Demographics
NPI:1093879660
Name:PHYSICAL THERAPY ASSOCIATES, INC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOPPE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:318-377-4028
Mailing Address - Street 1:906 HOMER RD
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-3024
Mailing Address - Country:US
Mailing Address - Phone:318-377-4028
Mailing Address - Fax:318-377-9895
Practice Address - Street 1:906 HOMER RD
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3024
Practice Address - Country:US
Practice Address - Phone:318-377-4028
Practice Address - Fax:318-377-9895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT-861225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAC3005OtherBLUE CROSS BLUE SHIELD LA
LA5S866Medicare ID - Type Unspecified