# ORTHOPEDIC & SPORTS THERAPY OF KENNER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kenner Orthopedic & Sports Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629148002
- **Authorized official:** MR. CRAIG M GOODWIN PT (PRESIDENT)
- **Authorized official phone:** (504) 443-5152

## Contact information

- **Practice address:** 3921 WILLIAMS BLVD, KENNER, LA 70065
- **Practice address phone:** (504) 443-5152
- **Practice address fax:** (504) 443-5151
- **Mailing address:** 3921 WILLIAMS BLVD, KENNER, LA 70065
- **Mailing address phone:** (504) 443-5152
- **Mailing address fax:** (504) 443-5151

## Taxonomy

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

## Other

- **Enumeration date:** 11/09/2006
- **Last updated:** 04/03/2014