Provider Demographics
NPI:1700190527
Name:GAITWAY THERAPEUTIC HORSEMANSHIP
Entity Type:Organization
Organization Name:GAITWAY THERAPEUTIC HORSEMANSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:225-766-1614
Mailing Address - Street 1:6555 PIKES LN
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4271
Mailing Address - Country:US
Mailing Address - Phone:225-766-1614
Mailing Address - Fax:225-757-1589
Practice Address - Street 1:1300 LAWRENCE PKWY
Practice Address - Street 2:
Practice Address - City:SAINT GABRIEL
Practice Address - State:LA
Practice Address - Zip Code:70776-5133
Practice Address - Country:US
Practice Address - Phone:225-766-1614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAA7654225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty