Organization
RENEW PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR J VARISCO O.T. (MANAGING MEMBER)
(337) 233-7701
Entity
Organization
Contact information
Practice address
19345 SUNSHINE AVENUE, COVINGTON, LA 70433
(985) 809-3940
(985) 809-3942
Mailing address
19345 SUNSHINE AVENUE, SUITE A, COVINGTON, LA 70433-8720
(985) 809-3940
(985) 809-3942
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
08/10/2007
Last updated
04/06/2011
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