# ST. JOHN PHYSICAL THERAPY, LLC

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

## Provider details

- **NPI number:** 1225242324
- **Authorized official:** MR. DERWARD THOMAS NORSWORTHY PHYSICAL THERAPIST (PHYSICAL THERAPIST)
- **Authorized official phone:** (985) 652-9515

## Contact information

- **Practice address:** 504 RUE DE SANTE, LA PLACE, LA 70068-5418
- **Practice address phone:** (985) 652-9515
- **Practice address fax:** (985) 652-8675
- **Mailing address:** 504 RUE DE SANTE, LA PLACE, LA 70068-5418
- **Mailing address phone:** (985) 652-9515
- **Mailing address fax:** (985) 652-8675

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/09/2007
- **Last updated:** 04/21/2022