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Organization subpart
No

Provider details

NPI number
Authorized official
SHERYL WADDELL (OFFICE MANAGER)
(985) 857-9097
Entity
Organization

Contact information

Practice address
4795 FREEDOM RD, HOUMA, LA 70360-2865
(985) 857-9097
(985) 857-9024
Mailing address
4795 FREEDOM RD, HOUMA, LA 70360-2865
(985) 857-9097
(985) 857-9024

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—

Other

Enumeration date
02/21/2007
Last updated
09/26/2008
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