Provider Demographics
NPI:1295075430
Name:HUSSEIN, JASON ALI (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:ALI
Last Name:HUSSEIN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5830 GLEN COVE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3832
Mailing Address - Country:US
Mailing Address - Phone:818-926-1360
Mailing Address - Fax:
Practice Address - Street 1:5830 GLEN COVE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3832
Practice Address - Country:US
Practice Address - Phone:818-926-1360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-26
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39895225100000X
LA09870R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist