Provider Demographics
NPI:1417437443
Name:CORE PHYSICAL THERAPY & SPORTS PERFORMANCE LLC
Entity Type:Organization
Organization Name:CORE PHYSICAL THERAPY & SPORTS PERFORMANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHET
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:STERNFELS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:985-384-1999
Mailing Address - Street 1:1340 ELM ST STE 101
Mailing Address - Street 2:
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380-1893
Mailing Address - Country:US
Mailing Address - Phone:985-384-1999
Mailing Address - Fax:985-384-1998
Practice Address - Street 1:1340 ELM ST STE 101
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1893
Practice Address - Country:US
Practice Address - Phone:985-384-1999
Practice Address - Fax:985-384-1998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT04181261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy