Provider Demographics
NPI:1649667445
Name:SCHULTZ PHYSICAL THERAPY OF BOGALUSA
Entity type:Organization
Organization Name:SCHULTZ PHYSICAL THERAPY OF BOGALUSA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING / OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-732-1651
Mailing Address - Street 1:414 AVENUE B
Mailing Address - Street 2:
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70427-3702
Mailing Address - Country:US
Mailing Address - Phone:985-732-1651
Mailing Address - Fax:985-241-5400
Practice Address - Street 1:414 AVENUE B
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-3702
Practice Address - Country:US
Practice Address - Phone:985-732-1651
Practice Address - Fax:985-241-5400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-20
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06707261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy