Provider Demographics
NPI:1346947751
Name:KATT, BRADLEY MICHAEL (DPT)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:MICHAEL
Last Name:KATT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 LIONS CLUB RD
Mailing Address - Street 2:
Mailing Address - City:SCOTT
Mailing Address - State:LA
Mailing Address - Zip Code:70583-5289
Mailing Address - Country:US
Mailing Address - Phone:337-769-1556
Mailing Address - Fax:337-769-1557
Practice Address - Street 1:113 LIONS CLUB RD
Practice Address - Street 2:
Practice Address - City:SCOTT
Practice Address - State:LA
Practice Address - Zip Code:70583-5289
Practice Address - Country:US
Practice Address - Phone:337-769-1556
Practice Address - Fax:337-769-1557
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11447225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA11447OtherLOUISIANA PHYSICAL THERAPY BOARD LICENSE