Provider Demographics
NPI:1972840544
Name:PHYSICIANS' CHOICE PHYSICAL THERAPY & PAIN CENTER LLC
Entity Type:Organization
Organization Name:PHYSICIANS' CHOICE PHYSICAL THERAPY & PAIN CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:TRUITT
Authorized Official - Last Name:JANNEY
Authorized Official - Suffix:SR
Authorized Official - Credentials:PT
Authorized Official - Phone:225-337-2801
Mailing Address - Street 1:PO BOX 1567
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-1567
Mailing Address - Country:US
Mailing Address - Phone:225-791-7788
Mailing Address - Fax:225-791-3938
Practice Address - Street 1:3123 WHITE SHADOWS DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-3709
Practice Address - Country:US
Practice Address - Phone:225-337-2801
Practice Address - Fax:225-791-3938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy