Individual
MRS. MARY BERAN HEUCHERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
6147 SHAKESPEARE DR, BATON ROUGE, LA 70817-2920
(225) 603-9138
Mailing address
6147 SHAKESPEARE DR, BATON ROUGE, LA 70817-2920
(225) 603-9138
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
01411
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01411
PART C
—
Enumeration date
04/02/2019
Last updated
04/02/2019
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