Individual
JODI F. AGNEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
15420 S HARRELLS FERRY RD STE D, BATON ROUGE, LA 70816-2933
(225) 751-9797
Mailing address
10101 PARK ROWE AVE STE 200, BATON ROUGE, LA 70810-1685
(225) 769-2200
(225) 768-2185
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A10400R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A10400R
LICENSE
LA
Enumeration date
09/18/2019
Last updated
09/18/2019
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