Provider Demographics
NPI:1255449914
Name:COOGLER, RICHARD BRIAN (PT, AT,C)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:BRIAN
Last Name:COOGLER
Suffix:
Gender:M
Credentials:PT, AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 PHOSPHOR AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-3233
Mailing Address - Country:US
Mailing Address - Phone:504-838-6061
Mailing Address - Fax:
Practice Address - Street 1:3901 HOUMA BLVD
Practice Address - Street 2:STE 300
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2930
Practice Address - Country:US
Practice Address - Phone:504-885-0007
Practice Address - Fax:504-455-0605
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA00416ROtherLICENSE #