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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