Organization
LOUISIANA CARDIAC VASCULAR AND PULMONARY REHAB LLC
Active
Other names
Louisiana Cardiac Vascular and Pulmonary Rehab LLC
Organization subpart
No
Provider details
NPI number
Authorized official
RAGHOTHAM R PATIOLA MD (CEO)
(337) 261-2633
Entity
Organization
Contact information
Practice address
2701 JOHNSTON STREET, STE 100, LAFAYETTE, LA 70503
(337) 261-2633
Mailing address
2701 JOHNSTON STREET, STE 100, LAFAYETTE, LA 70503
(337) 261-2633
Taxonomy
Speciality
Code
Description
License number
State
163WC3500X
Cardiac Rehabilitation Registered Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2701
—
LA
Enumeration date
11/18/2019
Last updated
11/18/2019
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