Provider Demographics
NPI:1649605882
Name:FOLSE, BART ANTHONY (ATC/L, OT-C)
Entity type:Individual
Prefix:MR
First Name:BART
Middle Name:ANTHONY
Last Name:FOLSE
Suffix:
Gender:M
Credentials:ATC/L, OT-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E SANTA CLARA ST
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-1100
Mailing Address - Country:US
Mailing Address - Phone:985-859-5657
Mailing Address - Fax:877-418-3157
Practice Address - Street 1:800 E SANTA CLARA ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-1100
Practice Address - Country:US
Practice Address - Phone:985-859-5657
Practice Address - Fax:877-418-3157
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAATH.2001462255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAH2167Medicare UPIN