# STAR PHYSICAL THERAPY NOE

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

## Provider details

- **NPI number:** 1467900654
- **Authorized official:** MR. RAVI BATES PT (MANAGER)
- **Authorized official phone:** (504) 243-6777

## Contact information

- **Practice address:** 340 FALCONER DR, COVINGTON, LA 70433-8204
- **Practice address phone:** (985) 893-2845
- **Practice address fax:** (985) 893-2654
- **Mailing address:** 5931 BULLARD AVE STE 6, NEW ORLEANS, LA 70128-2817
- **Mailing address phone:** (504) 243-6777
- **Mailing address fax:** (504) 243-6736

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 09469 | LA | Yes |

## Other

- **Enumeration date:** 09/15/2016
- **Last updated:** 09/15/2016