# NORTHSHORE PHYSICAL THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174308571
- **Authorized official:** DOMINIC MICHAEL ENGOLIA PT, DPT, OCS (MANAGER, PHYSICAL THERAPIST)
- **Authorized official phone:** (504) 655-2458

## Contact information

- **Practice address:** 217 INTREPID DR, SLIDELL, LA 70458-9110
- **Practice address phone:** (504) 655-2458
- **Mailing address:** 217 INTREPID DR, SLIDELL, LA 70458-9110
- **Mailing address phone:** (504) 655-2458

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 08/25/2023
- **Last updated:** 08/25/2023