Provider Demographics
NPI:1437311545
Name:ABE, LOUIS GEORGE (PTA)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:GEORGE
Last Name:ABE
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 LINCOLN RD
Mailing Address - Street 2:APT-19
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-7408
Mailing Address - Country:US
Mailing Address - Phone:530-674-8914
Mailing Address - Fax:
Practice Address - Street 1:745 LINCOLN RD
Practice Address - Street 2:APT-19
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-7401
Practice Address - Country:US
Practice Address - Phone:530-674-8914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT2170225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant