Provider Demographics
NPI:1245209436
Name:MCLEOD-TRAHAN-SHEFFIELD PHYSICAL THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:MCLEOD-TRAHAN-SHEFFIELD PHYSICAL THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEFFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:337-981-9182
Mailing Address - Street 1:2115 DULLES DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-2652
Mailing Address - Country:US
Mailing Address - Phone:337-981-9182
Mailing Address - Fax:337-988-3441
Practice Address - Street 1:2115 DULLES DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-2652
Practice Address - Country:US
Practice Address - Phone:337-981-9182
Practice Address - Fax:337-988-3441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAB4436OtherBLUE CROSS/BLUE SHIELD
LA5C497Medicare ID - Type UnspecifiedMEDICARE