Provider Demographics
NPI:1437256427
Name:LABBE', ANDRE' (PTMOMT)
Entity Type:Individual
Prefix:
First Name:ANDRE'
Middle Name:
Last Name:LABBE'
Suffix:
Gender:M
Credentials:PTMOMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:663 DODGE AVE
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:LA
Mailing Address - Zip Code:70121-1209
Mailing Address - Country:US
Mailing Address - Phone:504-818-2300
Mailing Address - Fax:504-818-0022
Practice Address - Street 1:107 WALL BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-7106
Practice Address - Country:US
Practice Address - Phone:504-392-0206
Practice Address - Fax:504-392-0289
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA01391225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4B355CS98Medicare ID - Type Unspecified