Organization
NORTHSHORE THERAPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA MILLER MOT, LOTR (PRESIDENT)
(985) 643-4263
Entity
Organization
Contact information
Practice address
2800 GAUSE BLVD E, SLIDELL, LA 70461-4247
(985) 643-4263
(985) 643-4774
Mailing address
2800 GAUSE BLVD E, SLIDELL, LA 70461-4247
(985) 643-4263
(985) 643-4774
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
OTT.200062
LA
335E00000X
Prosthetic/Orthotic Supplier
OTT.200062
LA
Other
Enumeration date
06/22/2007
Last updated
09/11/2025
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