Provider Demographics
NPI:1598213753
Name:LEVINS PHYSIOTHERAPY
Entity Type:Organization
Organization Name:LEVINS PHYSIOTHERAPY
Other - Org Name:PHYSIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:LEVINS
Authorized Official - Suffix:
Authorized Official - Credentials:PT, OCS, FAAOMPT
Authorized Official - Phone:225-773-0943
Mailing Address - Street 1:15029 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-5524
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3854 AMERICAN WAY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4013
Practice Address - Country:US
Practice Address - Phone:225-773-0943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA02644F261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy