Organization
SELECT PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. DIANNE GRAHAM PT (PHYSICAL THERAPIST)
(225) 769-9203
Entity
Organization
Contact information
Practice address
7932 SUMMA AVE, SUITE B3, BATON ROUGE, LA 70809-3416
(225) 769-9203
(225) 769-9205
Mailing address
7932 SUMMA AVE, SUITE B3, BATON ROUGE, LA 70809-3416
(225) 769-9203
(225) 769-9205
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H0011
BCBS OF LOUISIANA
LA
Enumeration date
05/11/2006
Last updated
08/22/2020
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