Provider Demographics
NPI:1336391523
Name:FIRST CHOICE THERAPY SERVICES,LLC
Entity Type:Organization
Organization Name:FIRST CHOICE THERAPY SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MISTRETTA
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:985-856-6337
Mailing Address - Street 1:144 VALHI LAGOON CROSSING
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-3208
Mailing Address - Country:US
Mailing Address - Phone:985-223-0032
Mailing Address - Fax:
Practice Address - Street 1:144 VALHI LAGOON XING
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-3208
Practice Address - Country:US
Practice Address - Phone:985-223-0032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA02594F225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty