# PHYSICAL THERAPY OF BATON ROUGE, INC

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

## Provider details

- **NPI number:** 1215028618
- **Authorized official:** MS. LORRAIN MACKAY P.T. (OWNER)
- **Authorized official phone:** (225) 751-3696

## Contact information

- **Practice address:** 2645 ONEAL LANE BLDG C, STE D, BATON ROUGE, LA 70816-3179
- **Practice address phone:** (225) 751-3696
- **Practice address fax:** (225) 751-3697
- **Mailing address:** 2645 ONEAL LANE BLDG C, STE D, BATON ROUGE, LA 70816-3179
- **Mailing address phone:** (225) 751-3696
- **Mailing address fax:** (225) 751-3697

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 00356 | LA | — |
| 225100000X | Physical Therapist | 00619 | LA | Yes |
| 225100000X | Physical Therapist | 01455F | LA | — |
| 225100000X | Physical Therapist | 02040F | LA | — |

## Other

- **Enumeration date:** 09/28/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | F6968 | BLUE CROSS OF | LA |