Organization
IMPACT PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DEREK LAURENT DPT (AUTHORIZED OFFICIAL)
(504) 491-5249
Entity
Organization
Contact information
Practice address
13702 COURSEY BLVD STE 10B, BATON ROUGE, LA 70817-1370
(504) 491-5249
Mailing address
13702 COURSEY BLVD STE 10B, BATON ROUGE, LA 70817-1370
(504) 491-5249
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
03/30/2021
Last updated
10/01/2023
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