# PONCHATOULA THERAPY

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

## Provider details

- **NPI number:** 1922398544
- **Authorized official:** CARRIE C HIGGS LOTR (DIRECTOR)
- **Authorized official phone:** (985) 969-0517

## Contact information

- **Practice address:** 132 S 6TH ST, PONCHATOULA, LA 70454-3317
- **Practice address phone:** (985) 969-0517
- **Mailing address:** 132 S 6TH ST, PONCHATOULA, LA 70454-3317
- **Mailing address phone:** (985) 969-0517

## 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:** 04/15/2011
- **Last updated:** 08/16/2021