Provider Demographics
NPI:1598349144
Name:LACOUR, LISA RITTER (PT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:RITTER
Last Name:LACOUR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5670 SOPHIE ANNE DR
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-2636
Mailing Address - Country:US
Mailing Address - Phone:225-936-2167
Mailing Address - Fax:
Practice Address - Street 1:4200 ROLLINS RD
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-2999
Practice Address - Country:US
Practice Address - Phone:225-654-2786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA01017225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist