Provider Demographics
NPI:1215353115
Name:STUDIO P3, LLC
Entity type:Organization
Organization Name:STUDIO P3, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUZANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:YORK-CRUMP
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:337-580-0083
Mailing Address - Street 1:266 OCKLEY DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-3025
Mailing Address - Country:US
Mailing Address - Phone:337-580-0083
Mailing Address - Fax:
Practice Address - Street 1:266 OCKLEY DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-3025
Practice Address - Country:US
Practice Address - Phone:337-580-0083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-16
Last Update Date:2014-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07638225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty