Organization
PREMIER MEDICAL REHAB LAPLACE INC
Active
Organization
PREMIER MEDICAL REHAB LAPLACE INC
Active
Other names
NEW BACK MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRI W BLOUIN (INSURANCE SUPERVISOR)
(985) 653-8903
Entity
Organization
Contact information
Practice address
900 W AIRLINE HWY, LA PLACE, LA 70068-3816
(985) 652-8100
(985) 652-8411
Mailing address
900 W AIRLINE HWY, LA PLACE, LA 70068-3816
(985) 652-8100
(985) 652-8411
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
415
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1941409
—
LA
Enumeration date
03/29/2007
Last updated
08/26/2009
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