Organization
LIFE FITNESS THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MEDY MANUEL PT (DIRECTOR)
(225) 769-0818
Entity
Organization
Contact information
Practice address
5438 ODONOVAN DR, SUITE 100, BATON ROUGE, LA 70808-4364
(225) 769-0818
(225) 769-0819
Mailing address
5438 ODONOVAN DR, SUITE 100, BATON ROUGE, LA 70808-4364
(225) 769-0818
(225) 769-0819
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
03638F
LA
261QP2000X
Physical Therapy Clinic/Center
PT01345F
LA
Other
Enumeration date
08/06/2008
Last updated
08/20/2013
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