Organization
PRIMARY REHABILITATION SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEO BLACKMER (PRESIDENT)
(337) 497-0434
Entity
Organization
Contact information
Practice address
4080 NELSON RD, SUITE 400, LAKE CHARLES, LA 70605-2418
(337) 497-0434
Mailing address
4080 NELSON RD, SUITE 400, LAKE CHARLES, LA 70605-2418
(337) 497-0434
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548928
—
LA
Enumeration date
06/24/2006
Last updated
07/21/2022
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