# BMMG, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CryoSpa
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083088520
- **Authorized official:** MR. MATTHEW FRANZ ST. AMANT (MEMBER)
- **Authorized official phone:** (318) 742-3408

## Contact information

- **Practice address:** 6030 LINE AVE, SHREVEPORT, LA 71106-2062
- **Practice address phone:** (318) 742-3408
- **Mailing address:** 816 BENTON RD, BOSSIER CITY, LA 71111-3744
- **Mailing address phone:** (318) 747-8895

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 08831R | TX | Yes |

## Other

- **Enumeration date:** 11/20/2015
- **Last updated:** 11/20/2015