Provider Demographics
NPI:1588730931
Name:HARGIS, CLAIRE MARIA (PT OCS)
Entity type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:MARIA
Last Name:HARGIS
Suffix:
Gender:F
Credentials:PT OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:13869 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAROSE
Mailing Address - State:LA
Mailing Address - Zip Code:70373-3062
Mailing Address - Country:US
Mailing Address - Phone:985-693-7300
Mailing Address - Fax:985-693-3845
Practice Address - Street 1:13869 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LAROSE
Practice Address - State:LA
Practice Address - Zip Code:70373-3062
Practice Address - Country:US
Practice Address - Phone:985-693-7300
Practice Address - Fax:985-693-3845
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA008592251X0800X, 2251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5X680Medicare PIN