Provider Demographics
NPI:1942435359
Name:OBRIEN, PATRICK E (PT)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:E
Last Name:OBRIEN
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 1:4715 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-3040
Mailing Address - Country:US
Mailing Address - Phone:225-923-0110
Mailing Address - Fax:225-923-0111
Practice Address - Street 1:4715 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-3040
Practice Address - Country:US
Practice Address - Phone:225-923-0110
Practice Address - Fax:225-923-0111
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07583225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist