Organization
ASCENSION PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY W PAIGE (OWNER LICENSED PHYSICAL THERAPIST)
(225) 473-4719
Entity
Organization
Contact information
Practice address
204 CLINIC DR, DONALDSONVILLE, LA 70346
(225) 473-4719
(225) 473-4719
Mailing address
204 CLINIC DR, DONALDSONVILLE, LA 70346
(225) 473-4719
(225) 473-4719
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG3282
RAILROAD MEDICARE
LA
Enumeration date
02/07/2007
Last updated
07/24/2008
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