Provider Demographics
NPI:1831468024
Name:WALKER PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:WALKER PHYSICAL THERAPY, LLC
Other - Org Name:ELITE PHYSICAL THERAPY AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LOUVIERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-397-3788
Mailing Address - Street 1:27999 OLD STH WALKER RD STE C
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-6048
Mailing Address - Country:US
Mailing Address - Phone:225-271-4083
Mailing Address - Fax:225-271-4208
Practice Address - Street 1:27999 OLD STH WALKER RD STE C
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:LA
Practice Address - Zip Code:70785-6048
Practice Address - Country:US
Practice Address - Phone:225-271-4083
Practice Address - Fax:225-271-4208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-19
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5DW85Medicare PIN