Provider Demographics
NPI:1336606011
Name:IN TOTO PHYSICAL THERAPY AND WELLNESS, LLC
Entity Type:Organization
Organization Name:IN TOTO PHYSICAL THERAPY AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:318-469-3285
Mailing Address - Street 1:333 TEXAS ST STE 1300
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-3783
Mailing Address - Country:US
Mailing Address - Phone:318-469-3285
Mailing Address - Fax:
Practice Address - Street 1:333 TEXAS ST STE 1300
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-3783
Practice Address - Country:US
Practice Address - Phone:318-469-3285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty