Provider Demographics
NPI:1194863688
Name:ADVANCED REHABILITATION OF ONEAL LANE
Entity Type:Organization
Organization Name:ADVANCED REHABILITATION OF ONEAL LANE
Other - Org Name:ADVANCED THERAPY SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:B
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-753-9491
Mailing Address - Street 1:16777 MEDICAL CENTER DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816
Mailing Address - Country:US
Mailing Address - Phone:225-753-9444
Mailing Address - Fax:225-753-9933
Practice Address - Street 1:16777 MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816
Practice Address - Country:US
Practice Address - Phone:225-753-9444
Practice Address - Fax:225-753-9933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy