Provider Demographics
NPI:1629317417
Name:FEDOR BRASWELL, WHITNEY (DPT)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:FEDOR BRASWELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 AIRLINE DR STE L
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-7213
Mailing Address - Country:US
Mailing Address - Phone:504-324-8345
Mailing Address - Fax:504-734-8869
Practice Address - Street 1:3434 PRYTANIA ST
Practice Address - Street 2:SU 310
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3532
Practice Address - Country:US
Practice Address - Phone:504-309-5461
Practice Address - Fax:504-309-5460
Is Sole Proprietor?:No
Enumeration Date:2013-02-14
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2251X0800X
ALPTH6724225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist