LOUISIANA STATE UNIVERSITY

NPI # 

Practice Address:

5213 Citrus Blvd Apt S335

River Ridge, LA, 70123-7229

Practice Phone:

504-343-2858

Practice Fax:

504-568-2127

License Number:

42398-66787

License State:

ZZ

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Rehabilitation

Taxonomy Code:

261QR0400X