Organization
MC2 ENTERPRISES, LLC
Active
Other names
Go Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA WALL P.T. (OWNER)
(225) 923-0110
Entity
Organization
Contact information
Practice address
4715 PERKINS RD, BATON ROUGE, LA 70808-3040
(225) 923-0110
(225) 923-0111
Mailing address
4715 PERKINS RD, BATON ROUGE, LA 70808-3040
(225) 923-0110
(225) 923-0111
Taxonomy
Speciality
Code
Description
License number
State
385HR2065X
Child Physical Disabilities Respite Care
Primary
—
LA
Other
Enumeration date
03/01/2007
Last updated
12/27/2007
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