Provider Demographics
NPI:1629246350
Name:LOUISA PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:LOUISA PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOUDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-967-1757
Mailing Address - Street 1:115 JEFFERSON HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LOUISA
Mailing Address - State:VA
Mailing Address - Zip Code:23093-6563
Mailing Address - Country:US
Mailing Address - Phone:540-967-1757
Mailing Address - Fax:540-967-0817
Practice Address - Street 1:115 JEFFERSON HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:LOUISA
Practice Address - State:VA
Practice Address - Zip Code:23093-6563
Practice Address - Country:US
Practice Address - Phone:540-967-1757
Practice Address - Fax:540-967-0817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty