Organization
LIFESPAN PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IME E UDOM PT, DPT, PHD (CLINICAL DIRECTOR)
(985) 594-8332
Entity
Organization
Contact information
Practice address
5108 HWY 56, CHAUVIN, LA 70344
(985) 594-8332
(985) 594-8389
Mailing address
PO BOX 58, CHAUVIN, LA 70344-0058
(985) 594-8332
(985) 594-8389
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/06/2006
Last updated
05/23/2025
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