Provider Demographics
NPI:1508937293
Name:ORTHOPEDIC & SPORTS THERAPY OF METAIRIE
Entity Type:Organization
Organization Name:ORTHOPEDIC & SPORTS THERAPY OF METAIRIE
Other - Org Name:METAIRIE ORTHOPEDIC & SPORTS THERAPY INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:WARE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:504-831-3227
Mailing Address - Street 1:701 METAIRIE RD
Mailing Address - Street 2:STE 1A 202
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005
Mailing Address - Country:US
Mailing Address - Phone:504-831-3227
Mailing Address - Fax:504-831-3284
Practice Address - Street 1:701 METAIRIE RD
Practice Address - Street 2:STE 1A 202
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005
Practice Address - Country:US
Practice Address - Phone:504-831-3227
Practice Address - Fax:504-831-3284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty