Provider Demographics
NPI:1437766961
Name:LOUISIANA CONCIERGE PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:LOUISIANA CONCIERGE PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEASLEE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS
Authorized Official - Phone:225-384-0503
Mailing Address - Street 1:10710 MISTY VALE AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-3030
Mailing Address - Country:US
Mailing Address - Phone:318-664-8278
Mailing Address - Fax:833-787-2261
Practice Address - Street 1:10710 MISTY VALE AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-3030
Practice Address - Country:US
Practice Address - Phone:318-664-8278
Practice Address - Fax:833-787-2261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy