Provider Demographics
NPI:1952370462
Name:ALLBRITTON, BETH (PT)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:
Last Name:ALLBRITTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 PARC PL
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-7281
Mailing Address - Country:US
Mailing Address - Phone:985-893-0778
Mailing Address - Fax:985-893-0301
Practice Address - Street 1:19105 SANDY LN
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-8715
Practice Address - Country:US
Practice Address - Phone:985-893-0778
Practice Address - Fax:985-893-0301
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT00878225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5C584Medicare ID - Type UnspecifiedGROUP PROVIDER #
LA5S793Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER #