Provider Demographics
NPI:1750638029
Name:HEBERT, JEFF (PT)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:HEBERT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 RIDGELAKE DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-4966
Mailing Address - Country:US
Mailing Address - Phone:504-309-0868
Mailing Address - Fax:504-309-0867
Practice Address - Street 1:2901 RIDGELAKE DR
Practice Address - Street 2:SUITE 107
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-4966
Practice Address - Country:US
Practice Address - Phone:504-309-0868
Practice Address - Fax:504-309-0867
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA002274225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist