Individual
MARY GEOGHEGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 CANAL ST, NEW ORLEANS, LA 70119-6535
(504) 507-2000
Mailing address
2400 CANAL ST, NEW ORLEANS, LA 70119-6535
(504) 507-2000
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
Primary
08661R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08661R
LOUISIANA PHYSICAL THERAPY BOARD
LA
Enumeration date
08/26/2020
Last updated
08/26/2020
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