# CULICCHIA NEUROLOGICAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CNC PHYSICAL THERAPY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1770850661
- **Legal business name:** CNC PHYSICAL THERAPY
- **Authorized official:** DARLA P ROST (BUSINESS OFFICE MANAGER)
- **Authorized official phone:** (504) 340-6976

## Contact information

- **Practice address:** 1111 MEDICAL CENTER BLVD, STE S750, MARRERO, LA 70072-3151
- **Practice address phone:** (504) 340-6976
- **Practice address fax:** (504) 349-6775
- **Mailing address:** 1111 MEDICAL CENTER BLVD, STE S750, MARRERO, LA 70072-3151
- **Mailing address phone:** (504) 340-6976

## Taxonomy

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

## Other

- **Enumeration date:** 11/21/2011
- **Last updated:** 11/21/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1797626 | — | LA |