Provider Demographics
NPI:1508526641
Name:PRECISION PHYSICAL THERAPY & SPORTS MEDICINE LLC
Entity Type:Organization
Organization Name:PRECISION PHYSICAL THERAPY & SPORTS MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBICHEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-634-1733
Mailing Address - Street 1:27616 BYERS LN
Mailing Address - Street 2:
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454-5742
Mailing Address - Country:US
Mailing Address - Phone:985-634-1733
Mailing Address - Fax:
Practice Address - Street 1:18539 HIGHWAY 22 STE F
Practice Address - Street 2:
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454-6710
Practice Address - Country:US
Practice Address - Phone:985-634-8322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty