Organization
SOUTHERN LOUISIANA REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH BOZZELLE MD (DIRECTOR)
(337) 837-3615
Entity
Organization
Contact information
Practice address
310A YOUNGSVILLE HWY, LAFAYETTE, LA 70508-4524
(337) 837-3615
(337) 839-8092
Mailing address
PO BOX 73701, METAIRIE, LA 70033-3701
(504) 888-1336
(504) 888-3362
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC2473
MEDICARE RAILROAD
LA
Enumeration date
05/20/2006
Last updated
02/03/2010
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